Vitamins and Epilepsy

What are vitamins?

Vitamins are organic substances that are generally classified as either fat soluble or water soluble (Harvard, 2022). Vitamins are needed for us to be able to have healthy cell function, growth, and development (Medline Plus, 2021). There are thirteen essential vitamins that the human body needs. They are Vitamin A, Vitamin C, Vitamin D, Vitamin E, Vitamin K, Vitamin B1, Vitamin B2, Vitamin B3, Vitamin B6, Vitamin B12, Vitamin B5 (Pantothenic Acid), Vitamin B7 (Biotin), and Vitamin B9 (Folate/Folic Acid). ?

Benefits of vitamins

Vitamins provide many benefits to our body. Fruits, vegetables, eggs, lean meats, and milk are examples of foods that contain essential vitamins for the body. Many people do not need to take vitamin supplements and can get the vitamins and minerals they need through proper diet and nutrition. Many people who are battling chronic illnesses such as epilepsy, benefit from supplements. Not all vitamins are beneficial for people with epilepsy, which is why you should discuss any changes to your treatment with your doctor, including adding vitamins to your care.

What vitamins benefit people with epilepsy?

There are vitamins that can help individuals with epilepsy reduce seizure activity. In the article, Natural approaches to epilepsy, nutrients that can help to reduce seizure frequency include vitamin B6, magnesium, vitamin E, manganese, taurine, dimethylglycine, and omega-3 fatty acids.

Vitamin B6

Vitamin B6 is a water-soluble vitamin found in many foods and supplements. Vitamin B6 helps to support immune function and brain health (Harvard, 2022). According to Harvard, the Recommended Dietary Allowance (RDA) for men 14-50 years is 1.3 mg daily, 1.7 mg for ages 51 and up. For women ages 14-18 is 1.2mg, 19-50 years, 1.3 and 1.5mg for ages 51 and up.

Magnesium

Magnesium is in a variety of foods and is responsible for carrying our various chemical reactions. Examples are building proteins, strong bones, regulating blood sugar, blood pressure, muscle function, and nerve function (Harvard, 2022). Magnesium serves also as an electrical conductor that contracts muscles and regulates the heartbeat (Harvard, 2022). According to Harvard, the Recommended Dietary Allowance (RDA) for adult men 19-51+ years of age is 400-420mg daily and 310-320mg daily for women.

Vitamin E

Vitamin E is a fat-soluble vitamin. Its role is to act as an antioxidant, scavenging loose electrons (aka free radicals) that can damage cells (Harvard, 2022). Vitamin E also enhances immune function and prevents clots from forming in the arteries of the heart (Harvard, 2022). According to Harvard, the Recommended Dietary Allowance (RDA) for men and women over the age of 14 is 15mg daily or 22 international units (IU).

Manganese

Manganese is a trace mineral that our bodies need. However the human body does not make manganese. Because of this, foods such as whole grains, oysters, mussels, nuts, soybeans, rice, and leafy vegetables are important and should be part of our nutrition intake (NIH, 2021). ?Manganese is responsible for breaking down carbohydrates, protein, and cholesterol as well as assisting enzymes in building bones. Manganese also helps in keeping the immune and reproductive systems running smoothly and working with Vitamin K to help in would healing and clotting of the blood (Harvard, 2022). According to Harvard, the Recommended Dietary Allowance (RDA) for adults 19+ is 2.3mg daily for men and 1.8mg for women.

Taurine

Taurine has an effect on the central nervous system. According to the article, Effects and Mechanisms of Taurine as a Therapeutic Agent, taurine protects the nervous system by agonizing GABAA, glycine, and NMDA receptors (El Idrissi et. al, 2003). By binding with the GABAA receptor, taurine has shown to decrease seizure activity (L’Amoreaux, Marsillo, and El Idrissi, 2010). Taurine also works to prevent seizure activity by elevating glutamic acid decarboxylase (El Idrissi and L’Amoreaux, 2008). Studies have shown that taurine acts as an inhibitory neuromodulator, yet only one third of patients responded favorably to taurine therapy (Schaffer and Kim, 2018). The most common dosage range for taurine is 500-3000mg daily (Van De Walle and Mawer, 2022).

Dimethylglycine

Dimethylglycine is a derivative of the amino acid glycine (MSKCC, 2022). Dimethylglycine is found in sources such as beans, cereal grains, brown rice, pumpkin seeds, and liver (MSKCC, 2022). It is produced in cells during the metabolism of choline and is considered an antioxidant and enhancer of oxygenation and the cellular level (MSKCC, 2022). There are mixed reviews about dimethylglycine being given to patients with epilepsy due to mixed results at clinical trials (MSKCC, 2022).

Omega-3 fatty acids

Omega-3 fatty acids are essential fats, yet our body does not produce them. Foods such as fish, nuts, flaxseed, and leafy vegetables are good sources of omega-3 fatty acids (Harvard, 2022). According to Harvard, omega 3’s are the starting point for making hormones that regulate blood clotting, contraction and relaxation of the arterial walls, and inflammation. Omega 3’s have shown to help in preventing heart disease and stroke and can help with the maintenance of lupus, eczema, and rheumatoid arthritis (Harvard, 2022). The recommended dietary allowance (RDA) for omega 3’s is 1.6g per day for men and 1.1g daily for women (Hjalmarsdottir, 2019). Many people get their source of omega 3’s by following a healthy diet rather than taking a supplement. ???????????????????????????????????????????????????????????????

What vitamins should people with epilepsy avoid?

There are supplements that have been tied to increasing seizure activity. In the article, Seizures reported in association with use of dietary supplements, ephedra, caffeine, St. John’s wort, and ginkgo biloba were associated with triggering seizure activity.

Ephedra

Ephedra, a natural ingredient in the Chinese herb ma huang, became popular for athletes and people who were obese due to its ability to help with weight loss, increasing energy, and alertness. It became one of the most dangerous supplements for many to use causing heart attacks, strokes, seizures, and sudden deaths (Harvard Health, 2017). Even though ephedra products only make up one percent of the herbal supplements sales in the United States, sixty two percent of herb-related reports to poison control are due to ephedra (Harvard Health, 2017). The Food and Drug Administration banned the sale of ephedra-containing products in 2004 after many clinical trials showed that ephedra did not produce the results that the manufacturers claimed. Even before ephedra was banned by the FDA, the Olympics, NFL, and US Military banned the use of ephedra.

Caffeine

Caffeine can be a trigger for some individuals with epilepsy. In the article, Caffeine and seizures: A systematic review and quantitative analysis, it was found that caffeine lowered the efficacy of several drugs, especially topiramate. Caffeine triggering seizures for individuals with epilepsy is rare, however it is something all individuals with epilepsy need to consider when it comes to their care.

St. John’s Wort

According to Mayo Clinic, St. John’s wort is a supplement that has been used to treat depression, menopausal symptoms, and somatic symptom disorder. St. John’s wort has been known to interact with anticonvulsant medication, increasing the risk for someone to have a seizure. A clinic trial from 2000-2001 was conducted to see the reaction St. John’s wort had with Tegretol (Carbamazepine). Results showed the St. John’s wort increased the metabolism of Tegretol, reducing the levels of Tegretol in the bloodstream (NIH, 2008).

Ginkgo Biloba

According to Mount Sinai, ginkgo biloba is one of the oldest tree species and has a long use in treating blood disorders and memory issues. Ginkgo biloba contains a toxic material in it known as ginkgotoxin. According to the American Chemical Society, ginkgotoxin seems to alter a chemical singling pathway that can trigger epileptic seizures. It has been known to have an effect on anticonvulsant medications, causing an increase of risk in seizure activity.

Vitamins as part of your care plan

When it comes to making any changes to your care plan such as starting to take vitamins, it is important to always discuss it with your neurologist or epileptologist. Depending on the type of epilepsy you have and what medication you take can determine what vitamins would be best for you.

Conclusion

Vitamins are organic substances that are generally classified as either fat soluble or water soluble (Harvard, 2022). Vitamins are needed for us to be able to have healthy cell function, growth, and development (Medline Plus, 2021). There are many vitamins and supplements that can be beneficial to individuals with epilepsy and some that should be avoided. Before adding any supplements to your plan, it is best to seek advice from your neurologist or epileptologist.

Resources:

American Chemical Society (2010). Ginkgo herbal medicines may increase seizures in people with epilepsy. American Chemical Society. Retrieved from: https://www.acs.org/content/acs/en/pressroom/presspacs/2010/acs-presspac-april-14-2010/ginkgo-herbal-medicines-may-increase-seizures-in-people-with-epiy.html

Clinical Trials NIH (2008). Drug Interaction Study of Tegretol (Carbamazepine) and St. John’s Work in Normal Volunteers. Clinical Trials, U.S. National Library of Medicine. Retrieved from: https://clinicaltrials.gov/ct2/show/NCT00006395

El Idrissi, A., & L'Amoreaux, W. J. (2008). Selective resistance of taurine-fed mice to isoniazide-potentiated seizures: in vivo functional test for the activity of glutamic acid decarboxylase. Neuroscience, 156(3), 693–699. https://doi.org/10.1016/j.neuroscience.2008.07.055

El Idrissi, A., Messing, J., Scalia, J., & Trenkner, E. (2003). Prevention of epileptic seizures by taurine. Advances in experimental medicine and biology, 526, 515–525. https://doi.org/10.1007/978-1-4615-0077-3_62

Gaby A. R. (2007). Natural approaches to epilepsy. Alternative medicine review : a journal of clinical therapeutic, 12(1), 9–24.

Haller, C. A., Meier, K. H., & Olson, K. R. (2005). Seizures reported in association with use of dietary supplements. Clinical toxicology (Philadelphia, Pa.), 43(1), 23–30. https://doi.org/10.1081/clt-44771

Harvard Medical School (2017). The dangers of the herb ephedra. Harvard Health Publishing, Harvard Medical School. Retrieved from: https://www.health.harvard.edu/staying-healthy/the-dangers-of-the-herb-ephedra

Harvard University (2022). The Nutrition Source: Vitamin B6. Harvard T.H. Chan School of Public Health. Retrieved from: https://www.hsph.harvard.edu/nutritionsource/vitamin-b6/?

Harvard University (2022). The Nutrition Source: Vitamin E. Harvard T.H. Chan School of Public Health. Retrieved from: https://www.hsph.harvard.edu/nutritionsource/vitamin-e/

Harvard University (2022). The Nutrition Source: Magnesium. Harvard T.H. Chan School of Public Health. Retrieved from: https://www.hsph.harvard.edu/nutritionsource/magnesium/

Harvard University (2022). The Nutrition Source: Manganese. Harvard T.H. Chan School of Public Health. Retrieved from: https://www.hsph.harvard.edu/nutritionsource/manganese/

Harvard University (2022). The Nutrition Source: Omega-3 Fatty Acids: An Essential Contribution. Harvard T.H. Chan School of Public Health. Retrieved from: https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/types-of-fat/omega-3-fats/

Harvard University (2022). The Nutrition Source: Vitamins and Minerals. Harvard T.H. Chan School of Public Health. Retrieved from: https://www.hsph.harvard.edu/nutritionsource/vitamins/

Hjalmarsdottir, F. (2019). How Much Omega-3 Should You Take per Day? Healthline. Retrieved from: https://www.healthline.com/nutrition/how-much-omega-3

L'Amoreaux, W. J., Marsillo, A., & El Idrissi, A. (2010). Pharmacological characterization of GABAA receptors in taurine-fed mice. Journal of biomedical science, 17 Suppl 1(Suppl 1), S14. https://doi.org/10.1186/1423-0127-17-S1-S14

Medline Plus (2021). Vitamins. Medline Plus, National Library of Medicine. Retrieved from: https://medlineplus.gov/ency/article/002399.htm

Memorial Sloan Kettering Cancer Center (MSKCC) (2022). Dimethylglycine: Purported Benefits, Side Effects & More. Memorial Sloan Kettering Cancer Center. Retrieved from: https://www.mskcc.org/cancer-care/integrative-medicine/herbs/dimethylglycine#msk_professional

Mount Sinai (2022). Ginkgo biloba. Mount Sinai Health Library. Retrieved from: https://www.mountsinai.org/health-library/herb/ginkgo-biloba

National Institute of Health, Office of Dietary Supplements (2021). Manganese. National Institute of Health, Office of Dietary Supplements U.S. Department of Health and Human Services. Retrieved from: https://ods.od.nih.gov/factsheets/Manganese-HealthProfessional/

Schaffer, S., & Kim, H. W. (2018). Effects and Mechanisms of Taurine as a Therapeutic Agent. Biomolecules & therapeutics, 26(3), 225–241. https://doi.org/10.4062/biomolther.2017.251

Van De Walle, G. and Mawer, R. (2022). What is Taurine? Benefits, Side Effects, and More. Healthline. Retrieved from: https://www.healthline.com/nutrition/what-is-taurine

van Koert, R. R., Bauer, P. R., Schuitema, I., Sander, J. W., & Visser, G. H. (2018). Caffeine and seizures: A systematic review and quantitative analysis. Epilepsy & behavior : E&B, 80, 37–47. https://doi.org/10.1016/j.yebeh.2017.11.003