High Homocysteine - Risk Factor for Alzheimer's Disease

Overview

Multiple researches revealed the statistically significant trend, showing that people with high blood levels of homocysteine have at least double than average risk of developing Alzheimer's disease later in life.  Homocysteine is created when the body uses the amino acid, methionine, for methylation.  Normally homocysteine is converted back to methionine, or used to create cysteine and other useful substances.  If these conversions are blocked homocysteine accumulates leading to a host of negative reactions.

Homocysteine, which damages blood vessels, nerves, and specifically mitochondria, has been linked to heart attacks, strokes, cancer (particularly colon, breast, and prostate cancer), Alzheimer's disease and other neurological diseases, depression, birth defects, gout, cervical dysplasia, erectile dysfunction and rheumatoid arthritis.

What is Homocysteine?

Homocysteine (ho-mo-SIS te-en) is an amino acid (a building block of protein) that is produced in the human body. Homocysteine may irritate blood vessels, leading to blockages in the arteries, called atherosclerosis. High homocysteine levels in the blood can also cause cholesterol to change to something called oxidized lowdensity lipoprotein, which is more damaging to the arteries.

In addition, high homocysteine levels can cause blood clots to form more easily than they should, increasing the risk of blood vessel blockages. A blockage might cause you to have a stroke or a problem with blood flow. Up to 20% of people with heart disease have high homocysteine levels.

Homocysteine is normally changed into other amino acids for use by the body. If your homocysteine level is too high, you may not have enough B vitamins to help this process. Or you may not have enough of the enzymes to process homocysteine.

The B Vitamins Reducing Homocysteine

Efficient conversion of homocysteine requires certain nutrients, which neutralize homocysteine’s toxicity by transforming it into useful substances.  The most well-studies nutrients are folic acid, vitamin B12, and vitamin B6. Choline, betaine (TMG), creatine, riboflavin, zinc, magnesium and other nutrients also help detoxify homocysteine.

Based on the association between elevated homocysteine and Alzheimer’s disease, strategies that lower homocysteine levels to safe ranges, including supplementation with B vitamins, are recommended.

Vitamin B12

Research has suggested that low cobalamin (vitamin B12) levels are related to dementias in general. In a study evaluating levels of vitamin B12 in patients who had Alzheimer’s disease or frontotemporal dementia, researchers found a significant negative correlation (the lower the level of vitamin B12, the more the deterioration) between vitamin B12 and degree of cognitive deterioration. A population-based longitudinal study in Sweden of 370 people aged 75 years or older who did not have dementia found that subjects who had low levels of vitamin B12 or folate had twice the risk of developing Alzheimer’s disease over the 3-year period of the study.

Vitamin B6

A study found significantly lower consumption of vitamin B6 after age 60 years in patients with Alzheimer’s disease compared to control subjects. Low vitamin B6 levels are also associated with elevated numbers of lesions on the brains of patients with Alzheimer’s disease.

Folate (a form of vitamin B9)

Folic acid is needed for DNA synthesis and to make S-adenosylmethionine (SAMe). A study of 126 patients, including 30 who had Alzheimer’s disease, found that the levels of folate in cerebrospinal fluid were significantly lower in patients with late-onset Alzheimer’s disease. Another longitudinal analysis of people between the ages of 70 and 79 years found that people who had high levels of homocysteine or low levels of folate had impaired cognitive function. The strongest association between abnormal levels and dementia was found in people who had low folate levels, leading researchers to suggest that folate might reduce the risk of cognitive decline.

Your Diet

Dr. David Snowden shows in his Kentucky Nuns Study that nuns who were most likely to suffer Alzheimer's disease have low blood levels of the vitamin folic acid and high levels of the protein building block homocysteine. Not eating enough leafy greens and whole grains can deprive you of the vitamin folic acid, and eating too much meat provides you with too much methionine, and the combination of these two factors raises brain levels of homocysteine, that punches holes in arteries and causes plaques to form in them to cause ministrokes, which damages your brain.

Methionine is an essential protein building block that your body uses to make another nonessential building block called cysteine. If you lack any of the three vitamins: B12, folic acid or pyridoxine, methionine is converted to a poison called homocysteine that damages arteries and causes strokes, heart attacks and Alzheimer's disease. Meat is one of the richest sources of methionine, and leafy greens and whole grains are full of folic acid that prevents methionine from being converted to homocysteine. Reducing your intake of meat and poultry lowers your intake of methionine. Folic acid is found everywhere in nature that you get carbohydrates, because folic acid helps your body convert carbohydrates to energy. You can help to prevent Alzheimer's disease by getting folic acid from all whole grains and fortified cereals, leafy green vegetables, beans, seeds, nuts, and many other plants; and by reducing your intake of methionine by eating less meat.

The amount of vitamin B12 actually needed by the body is very small, probably only about 2 micrograms or 2 millionth of a gram/day. Unfortunately, vitamin B12 is not absorbed very well so much larger amounts need to be supplied through the diet or supplementation. The richest dietary sources of vitamin B12 are liver, especially lamb's liver, and kidneys. Eggs, cheese and some species of fish also supply small amounts, but vegetables and fruits are very poor sources. Several surveys have shown that most strict, long-term vegetarians are vitamin B12 deficient. Many elderly people are also deficient because their production of the intrinsic factor needed to absorb the vitamin from the small intestine decline rapidly with age.

 Vitamin B6 is found in a wide variety of foods including fortified cereals, beans, meat, poultry, fish, and some fruits and vegetables. The best sources of vitamin B6 include spinach, bell peppers, and turnip greens. Very good food sources of vitamin B6 include garlic, tuna, cauliflower, mustard greens, banana, celery, cabbage, crimini mushrooms, asparagus, broccoli, kale, collard greens, Brussels sprouts, cod and chard.

Vitamin B Supplements

The usual recommended vitamin and folate doses for lowering homocysteine levels are as follows: a daily multivitamin containing 400 μg of folate and less than 5 mEq of iron. An additional 800 μg of folate per day for 8 weeks. If this does not lower your homocysteine level, you may need a higher dose.

It is important to get your homocysteine level rechecked after you have been taking the multivitamin and folate for 8 weeks. If your homocysteine level remains high, you may need to take more folate (2 mg per day). If you have had a high homocysteine level, you may need to have your level checked later.

Sources and Additional Information:

http://www.compassionateacupuncture.com/preventing_alzheimer.htm

http://www.present-truth.org/7-Health-Secrets-Sem/Diseases/Alzhiemers.pdf

http://www.lef.org/protocols/neurological/alzheimers_disease_02.htm

http://www.drmirkin.com/morehealth/9894.html

http://www.yourhealthbase.com/vitamin_B12.html

Alzheimer's Disease and Diet

People with Alzheimer’s should eat well-balanced, nutrient-rich meals, but a special diet is usually not necessary. However, even healthy older people experience changes in eating habits as they age: Food may not smell or taste the same; it may become more difficult to chew and digest food, and our cells may not be able to utilize the energy from food as efficiently. These problems may be more pronounced in people with Alzheimer’s and may be compounded by other challenges posed by the disease. In addition, Alzheimer’s may cause appetite control systems in the brain to malfunction as nerve cells in those areas deteriorate, resulting in extreme eating behaviors (overeating or not eating at all).

In early stages of the disease, people with Alzheimer’s may have difficulty preparing meals. They may forget they have food in the oven or cook something and forget to eat it. Step-by-step written or verbal instructions clearly delineating what to do to prepare and eat meals may be beneficial in such cases.

Food preparation problems may progress to difficulty eating. Nerve cell death eventually steals the ability to recognize thirst or hunger. At the same time, depth perception may be compromised due to changes in the visual and “mapping” areas of the brain, making the process of eating more frustrating. The person may no longer know how to use a knife or fork and may lose interest in food altogether.

That may become very difficult and stressful as there will come a time when a sufferer forgets to eat, forgets that they have already eaten and basically forgets how to eat. At this point it will be the caregiver who takes over the role of ensuring that the person gets a good balance of the right food.

Sometimes a patient’s medication can put them off their food. Or because of the degenerative nature of the illness they may not be physically able to use a knife and fork or even swallow. Despite all these hurdles the caregiver must try to ensure that they have a balanced diet full of fruit, vegetables, dairy products and proteins. This will help to keep the sufferer’s body as healthy as possible at a time when their brain function is deteriorating.

Oily fish is particularly good as it’s rich in Omega 3 oils which are known to help concentration and maintain a healthy heart and nervous system.

It’s a good idea to prepare finger food (with soft, healthy fillings such as egg or tuna) as the illness progresses. These are easier for the sufferer to handle and chew, giving them some control and independence over what they are doing. It also makes life easier for sufferers who get restless and agitated if they have to sit at a table for any length of time to eat a meal.

Providing healthy snacks such as fruit or raw vegetables is ideal if a person has a tendency to overeat because they have forgotten they’ve already had a meal.

According to several studies, eating plenty of darkly colored fruits and vegetables may slow brain aging. Of interest was a 1999 study on animals, in which extracts taken from blueberries and strawberries actually reversed age-related decline in brain function. Blueberries were the most effective. Dark-colored fruits and vegetables are recommended in any case for good health.

People with dementia don’t realize that they may be thirsty. It’s important that fluid levels are kept up to avoid dehydration (which can make the mind even more sluggish) and constipation. For the latter, the person’s diet should also contain healthy amounts of fiber such as whole meal bread or wholegrain cereals.

The traditional approach claims that avoiding alcohol is important as not only does it dehydrate but it can also cause a worsening of the confusion and memory loss symptoms. However, several studies have suggested that moderate intake of alcohol (one or two drinks a day) of any kind may protect the aging brain, possibly by releasing acetylcholine, the chemical in the brain that is deficient in Alzheimer's disease. Although most studies have focused on wine, a 2001 Dutch study found that light to moderate alcohol intake, regardless of alcohol type, helped protect against dementia, including Alzheimer's. Not all studies have been positive. One, for example, suggested that wine may have some protective properties for noncarriers of ApoE4 but actually increase the risk for carriers of the gene. In any case, heavy alcohol consumption offers no protection and is dangerous.

The acceptability of low amount of alcohol in Alzheimer’s patient diet was supported by the recent study, getting results on the positive influence of the Mediterranean diet in comparison with more traditional Western diet, higher in saturated fat and meats and lower in fruits and vegetables. The Mediterranean diet includes a high intake of vegetables, legumes, fruits, cereals, fish, monounsaturated fatty acids; a low intake of saturated fatty acids, dairy products, meat and poultry; and a mild to moderate amount of alcohol.

Sources and Additional Information:

http://www.guide4living.com/alzheimers/diet-exercise.htm

http://www.alzinfo.org/08/treatment-care/diet-exercise-health

http://neurology.health-cares.net/alzheimers-disease-diet.php

http://www.sciencedaily.com/releases/2007/09/070910162411.htm

http://alzheimers-review.blogspot.com/2009/11/red-wine-as-effective-weapon-against.html