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Parkinson's, B6, B12, and Folate - What's the Connection?

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Parkinson's, B6, B12, and Folate - What's the Connection?
Kathrynne Holden, MS
Copyright 2008-2014

Ms. Holden is a nutritionist specializing in Parkinson's
disease. She has published research, books, articles, and manuals on
nutrition and PD, including "Eat well, stay well with Parkinson's
disease." She moderates the NPF forum "Ask About Nutrition" at:
www.parkinson.org

In the past decade, there has been increasing interest among
researchers about the effects of three B vitamins - B6, B12, and folate.
We now know that deficiencies occur with greater frequency than ever
suspected previously, particularly in older adults. We also now know
that deficiencies, if not corrected, can result in irreversible damage
in some people. Some health professionals are beginning to suspect that
these three vitamins may be significant factors in Parkinson's disease.

What are B6, B12, and folate, and what do they do?

These are essential nutrients, meaning that they are vital to life.
These three vitamins work both independently and together in many of the
body's systems.

Vitamin B6 assists in making hormones, new proteins, and
neurotransmitters ("messengers" between nerve cells) for the body's use.
It also helps release stored sugar when we need it for fuel. It works
together with B12 and folate to remove homocysteine from the blood.
Homocysteine is a substance increasingly associated with a number of
diseases; more about this later.

Vitamin B12 plays a role in the synthesis of DNA, needed for formation
of new red blood cells. It takes part in the manufacture of the myelin
sheath - the protective coating that surrounds nerve cells. With B6 and
folate it removes homocysteine from the blood.

Folate, also called folacin or folic acid, is a partner with B12 in DNA
synthesis and in removal of homocysteine, and is required in many other
vital processes. Without folate, B12 would be unable to complete many of
its functions, and vice versa. Folate is the form found in foods, folic
acid is the form in dietary supplements.

How much do we need of these vitamins?

Nutrient needs are broken down by gender, age group, pregnancy, and
lactation. New guidelines have also established a Tolerable Upper Intake
Level. So, for example, while the RDA for vitamin B6 for males and
females age 19-30 years is 1.3 mg/day, the Tolerable Upper Intake Level
for both is 100 mg/day, making it easier to provide recommended amounts.


RDA* Tolerable Upper Intake Level ** +

Vitamin B6*** + 1.7 mg/day 100 mg/day (age 19 and older)

Vitamin B12 + 2.4 mcg/day Not Determined

Folate + 400 mcg/day 1000 mcg/day


* Recommended Dietary Allowance
** The Tolerable Upper Intake Level is the maximum level of daily
nutrient intake that is likely to pose no risk of adverse effects, and
represents the total intake from food, water, and supplements.
*** Adults age 51 and older
+ not applicable if pregnant or lactating

Why do deficiencies occur, and what are signs of deficiencies?

Vitamin B6. Mild deficiencies of B6 are fairly common in the U.S.,
mostly because of dietary deficiencies, but sometimes due to use of
certain medications which interfere with B6, including hydralazine,
isoniazid, MAO inhibitors, penicillamine, and theophylline. (Conversely,
large amounts of B6 can interfere with the absorption of levodopa, an
important medication for Parkinson's disease. Current use of the
combinations of carbidopa-levodopa or benserazide-levodopa offset this
interaction for the most part; but use of supplements containing more
than 15 mg of B6 can overwhelm the protective effects of the carbidopa
and benserazide.)

Good food sources of B6 include chicken, fish, eggs, nuts and seeds,
dried beans and peas, soybeans, wheat germ, bananas, avocados, and
brewer's yeast. Also, some foods, including a number of breakfast
cereals, are fortified with B6.

Signs of B6 deficiency include irritability, depression, and confusion;
sore tongue, sores or ulcers of the mouth, and ulcers of the skin at the
corners of the mouth.

Vitamin B12. The human body stores this vitamin so well that it can
take a long time to deplete, sometimes several years. Nevertheless,
there are several reasons why people sometimes do experience deficiency.
Animal foods are the only source of B12, therefore people who eat few or
no animal products (meat, fish, poultry, eggs, milk) are at risk unless
they use vitamin supplements.

Another problem is that B12 in foods cannot be absorbed by the body
until it is freed from the proteins in the food; the stomach produces an
acid that removes this protein. However, with age, we produce less and
less of this stomach acid. Many older adults don't produce enough acid
to allow them to absorb B12. Further, people who have acid reflux often
use medications that reduce stomach acid, which unfortunately also
decreases absorption of B12. Vitamin B12 is one of the few nutrients
that is better absorbed in pill form than from dietary sources.

Signs of B12 deficiency include numbness or a tingling "pins and
needles" sensation, or a burning feeling; a red, sore, or burning
tongue; loss of appetite; gait abnormalities, personality changes, an
Alzheimer-like dementia, psychosis, depression, and agitation,
particularly in older adults. Other signs are megaloblastic anemia, and
elevated serum homocysteine, in people of all ages. Researchers believe
that as many as 42% of people aged 65 and older may have some degree of
B12 deficiency. Many people with PD are age 65 or older, and should be
considered at risk and tested for B12 deficiency.

Folate. Folate is available in many foods: lima beans, brewer's yeast,
orange juice, dried beans, green peas, asparagus, beets, Brussels
sprouts, broccoli, corn, spinach and other dark green leafy vegetables,
soybeans, nuts and seeds. Further, the U.S. government requires that
food manufacturers fortify processed grain products with folic acid.
Yet, deficiencies of folate are not uncommon. This could be in part
because folate is another of the few nutrients in which the synthetic
form is absorbed much better (about 40 percent better) than the natural
form.

Because of the possibility of deficiency, women, including women with
PD, who are pregnant or wish to become pregnant are advised to take
supplements of folic acid; deficiencies can result in neural tube
defects in the unborn child.

Deficiencies of folate are also being increasingly studied for a
possible role in other diseases:

. A low intake of folic acid is associated with risk for colon cancer.
Chronic constipation, experienced by many people with PD, also increases
risk for colon cancer; it is prudent for those with PD to control
constipation and to be sure the diet is adequate in folate.
. A low level of folic acid in the blood is associated with higher
levels of serum homocysteine, a substance in the blood that may
contribute to heart disease, stroke, and dementias.
. Animal studies point to a link between low levels of folic acid and
Alzheimer's disease; and people with Alzheimer's are often found to have
low levels of folic acid. Some people with PD develop an Alzheimer-type
dementia. Again, prudence dictates consumption of adequate folate.
. Another study using mice found that folic acid deficiency led to
increased levels of homocysteine and symptoms of Parkinson's disease.
Researchers speculate that homocysteine may damage DNA in the substantia
nigra, the area of the brain affected in Parkinson's disease.
. There are reports of improvement in restless leg syndrome (RLS) with
use of folate supplements; this has not as yet been studied thoroughly,
so it is too early to say whether there is a definite link. However,
people with PD often complain of RLS, and physicians should rule out the
possibility of folic acid deficiency.
Signs of folic acid deficiency include appetite loss, weight loss,
burning tongue, fatigue, weakness, shortness of breach, memory loss,
irritability, megaloblastic anemia, and increased levels of serum
homocysteine.

Should people with PD be concerned about these vitamins?

Although there are concerns, as mentioned above, that deserve further
study, it's too early to say definitely that these three vitamins are of
significance to people with PD. However, if you are over age 50 these
vitamins are of importance independently of PD. Furthermore, studies
have demonstrated that some people who use levodopa, considered the best
medication for PD, develop elevated levels of serum homocysteine, due to
the way in which the medication is metabolized. It is certainly a good
idea to ask your doctor to test levels of serum homocysteine annually,
and to check for signs of B vitamin deficiencies.

Should you take supplements?

There is growing agreement that older adults are at risk for nutrient
deficiency, whether PD is present or not, and that supplements can help.

. One study of older adults found that a multivitamin containing 100% of
the Daily Value improved low levels of several nutrients, including
vitamins B6, B12, and folate.
. A recent study in the United Kingdom suggests that folic acid intake
should be about three times that of the current recommendation for
elderly people.
. Other studies indicate that up to 10% of older adults with low-normal
levels of B12 are actually deficient and could benefit from supplements.
Because folate supplements can mask a B12 deficiency, it becomes extra
important to get enough B12 daily.
. The American Heart Association recommends a folate-rich diet to lower
homocysteine levels, and supplements of 2 mg B6, 400 mcg folic acid, and
6 mcg of B12 if dietary means are not sufficient to lower the
homocysteine.

For people with PD who use a medication that contains levodopa (such as
Sinemet, Madopar, Syndopa, Larodopa, etc.), you should be aware that
large amounts of vitamin B6 (more than 15 mg) can affect the absorption
of levodopa, by converting levodopa to dopamine in the stomach and
bloodstream. Dopamine cannot cross the blood-brain barrier, so it is
effectively blocked from its purpose.

Sinemet and Madopar contain either carbidopa or benserazide, which
"protect" the levodopa from B6; so ordinary supplements of B6 should not
be a problem for most people. However, very large amounts of B6, greater
than 15 mg (and in sensitive persons, possibly as low as 10 mg), could
overwhelm the protective effects of the carbidopa or benserazide. Such a
supplement should be taken at bedtime with a light snack, or with meals
at least two hours separately from levodopa.

In summary, older adults are acknowledged to be at increased risk for B
vitamin deficiencies. People with PD who are age 50 and over, therefore,
are at increased risk also. Whether younger people with PD should be
concerned about such deficiencies remains to be seen. A prudent and
rational approach for all those with PD is to:

. Discuss the possibility with their physicians, and to request tests
for B vitamin deficiencies
. Be aware of the signs of B vitamin deficiency
. Take a multivitamin/mineral supplement daily. Unless anemic, choose a
supplement that does not contain iron
. Take a B complex supplement if deficiencies occur; and take the
supplement separately from levodopa by at least two hours, preferably
with meals or a snack.

Knowledge is strength; awareness of dietary needs can prevent illness,
malnutrition, suffering, and hospitalization. If you have questions
about B vitamins or other nutrition or dietary needs, please visit the
National Parkinson Foundation website:
<http://www.parkinson.org and click on "Ask About Nutrition."

The above article may not be reproduced in any form except with
permission from the author.

References

Giovannucci, E. et al. Alcohol, low-methionine-low-folate diets, and
risk of colon cancer in men. Journal of the National Cancer Institute.
1995; volume 87: pages 265-273.

Kruman II, Kumaravel TS, Lohani A, Pedersen WA, Cutler RG, Kruman Y,
Haughey N, Lee J, Evans M, Mattson MP. Folic Acid deficiency and
homocysteine impair DNA repair in hippocampal neurons and sensitize them
to amyloid toxicity in experimental models of Alzheimer's disease. J
Neurosci 2002 Mar 1;22(5):1752-62.

Lobo A, Naso A, Arheart K, Kruger WD, Abou-Ghazala T, Alsous F, Nahlawi
M, Gupta A, Moustapha A, van Lente F, Jacobsen DW, Robinson K. Reduction
of homocysteine levels in coronary artery disease by low-dose folic acid
combined with vitamins B6 and B12. Am J Cardiol 1999 Mar 15;83(6):821-5.

Malinow, M.R. et al. Homocyst(e)ine, diet, and cardiovascular diseases:
a statement for healthcare professionals from the nutrition committee,
American Heart Association. Circulation. 1999; volume 99: pages 178-182.

Muller T, Werne B, Fowler B, Kuhn W. Nigral endothelial dysfunction,
homocysteine, and Parkinson's disease. Lancet. 1999 Jul
10;354(9173):126-7.

Muller T, Woitalla D, Hauptmann B, Fowler B, Kuhn W. Decrease of
methionine and S-adenosylmethionine and increase of homocysteine in
treated patients with Parkinson's disease.
Neurosci Lett. 2001 Jul 27;308(1):54-6.

Naurath HJ, Joosten E, Riezler R, Stabler SP, Allen RH, Lindenbaum J.
Effects of vitamin B12, folate, and vitamin B6 supplements in elderly
people with normal serum vitamin concentrations. Lancet 1995; 346:85-89.

O'Keeffe ST. Restless legs syndrome. A review. Arch Intern Med.
1996;156:243-248.

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Thanks for the great info on b vitamins.

 

Since b vitamins is a water saluable vitamin I'm guessing it should be fine to just start supplementing?

 

If so or not, for future references.. Does brand of the vitamins matter?.. I've done some light research and noticed some are more expensive than others.. Also some can be natural and synthetic.. I know the difference but is that true?... If so what do u recommend.. As far as brands and kind.

 

Also I've been wanting to take some magnisium pill form cuz I lack it in my diet.. I'm a male, 32... So would it be safe if I took it with 600 mg of calcium pill form?.. I'm hearing its bad for a male to take pill form calcium cuz it can cause calcification.. Is 600mg of calcium a safe dose if that's true?

 

Thank u.

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Yes, it should be fine to supplement B vitamins. Unless you have tested deficient for a particular B vitamin, a B-complex would be a good idea, as several of the Bs work together to accomplish their purposes. Usually, the natural form of vitamins is best, but the B vitamins in synthetic form have performed well. Here are some brands that have passed ConsumerLabs testing:

 

Life Extension Complete B Complex

Thorne Research Stress B Complex

Vitamin Life Raw B Code Vitamin Complex

 

Calcium and magnesium do work well together. I wouldn't overdo calcium; if you drink calcium-fortified orange juice, or eat fortified cereal, or dark green leafy vegetables such as kale and collards, you are probably getting enough calcium. But if not, then a small amount -- 200 - 400 mg / day -- is probably a good idea. Calcium citrate can be taken with or without meals, and does not constipate (as calcium carbonate can).

 

For magnesium -- vegetables, fruits, and nuts are good sources, and the magnesium is absorbed better than from pills, which is why it's ideal to eat several servings of each in the daily menu. But if you eat mainly processed foods, then it's possible the magnesium has been stripped away. About 400 mg a day would be good, preferably in divided doses of 100 mg each. Mg glycinate is good if constipation is a concern. If muscle pain is present, then magnesium malate. Otherwise magnesium citrate is a good choice.
 

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Thank u again.

 

Those b vitamins u mentioned look promising.

 

I don't drink milk and do drink orange juice but it's not daily.. I'll take a low dose of 200mg of calcium citrate.

 

I run constipated.. Always have been but lately I find myself waiting three days for a bowel movement and for that I wanted to introduce magnisium.. We'll actually I have for the past week and magnisium citrate made my bowels watery.. But this is the weird part, only a little bit comes out.. As if I'm just getting rid of what's in my colon but I'm not getting everything pushed out... U get what I'm saying?.. Or it feels like that... I also have twitches everywhere and I don't know the cause of them so I knew low magnesium can cause that so I was looking to kill two birds with one stone... I'm looking to get magnisium glycinate and see how that works.

 

Also if u can answer this question.. Months ago I tested normal on magnesium.. Is it possible that I might still lack it in my body?

 

Thank u.

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Bill, if you have always been constipated, and now find that your bowel movements are watery and unusually scanty, then I am concerned that you might have a condition called "bowel impaction." This can happen when chronic constipation stretches the colon so that the stool stays in one place instead of moving along. Any stool behind it then gets added to the mass and it becomes impacted. Watery stool that has just entered the colon may sometimes pass around the impacted mass, so that the person has small, watery bowel movements.

 

Signs of impaction don't always occur immediately, but in time can show up as a swollen, tender, or painful abdomen, along with watery stools. I urge you to discuss this with your doctor as soon as possible, as bowel impaction can be quite serious, sometimes requiring hospitalization.

 

If you tested within normal limits for magnesium within the past six months, I would not normally expect to see a deficiency; but everyone is different, and PD can affect people differently as well. I would speak to your doctor about the possibility of bowel impaction and also ask whether a new test for magnesium might be needed. And I would describe these 'twitches' to your neurologist, and ask what might be causing them -- it might not be low magnesium, but a side effect of medications or a PD symptom.

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Maybe I shouldn't have used water stool... What I meant to say its a loose stool, this only happens when I take magnisium citrate.. If I take magnisium citrate everyday I'll have a bowel movement everyday but it will be a loose stool and very little... If I don't take magnisium citrate I'll have a bowl movement every three to four days, it will be one solid piece, about five inches long in one piece.. At times it can come out in multiple smaller pieces... Sometimes I feel relieved even though it's a small amount but other times I feel like I can or should have more to come out... What I find odd is I don't have that feeling like I have to have a bowl movement, it's like I have to go make a effort to get it out... I'll sit on the toilet and rock back and fourth to get it out and it works... I'am only 115 pounds, idk if that applies to anything.

 

 

I do have zero pain in my abdomen, sometimes after eating it feels bloated.

 

Also I'm not diagnosed with pd, I visit the site to see other peoples symptoms and see if there is a match.. I have a light balance problem at times and twitches.. I'm currently seeing a doctor and neurologist.. On next visit I'll tell them about my bowel movements.

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Maybe I shouldn't have used water stool... What I meant to say its a loose stool, this only happens when I take magnisium citrate.. If I take magnisium citrate everyday I'll have a bowel movement everyday but it will be a loose stool and very little... If I don't take magnisium citrate I'll have a bowl movement every three to four days, it will be one solid piece, about five inches long in one piece.. At times it can come out in multiple smaller pieces... Sometimes I feel relieved even though it's a small amount but other times I feel like I can or should have more to come out... What I find odd is I don't have that feeling like I have to have a bowl movement, it's like I have to go make a effort to get it out... I'll sit on the toilet and rock back and fourth to get it out and it works... I'am only 115 pounds, idk if that applies to anything.

 

 

I do have zero pain in my abdomen, sometimes after eating it feels bloated.

 

Also I'm not diagnosed with pd, I visit the site to see other peoples symptoms and see if there is a match.. I have a light balance problem at times and twitches.. I'm currently seeing a doctor and neurologist.. On next visit I'll tell them about my bowel movements.

 

 

 

 

Bill, I would ask your neurologist about use of Miralax for constipation. This laxative is designed for people whose constipation is due to slowed peristalsis, the movement of the colon that pushes the stool along, and eventually expels it. I would also ask about the post-meal bloating. Sometimes this can be due to gastroparesis - slowed stomach emptying; or to small bowel overgrowth, a condition of inflammation in the small intestine. Your doctor may want to rule out these possibilities.

 

 

 

 

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Thanks for sharing.

This article are very  useful for me.Keep it up.

 

I'm glad the information is useful for you, and don't hesitate to post any questions that may come up.

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Hi Kathrynne,

Me again. Question regarding B6, my level is 15. Should I need to increase this?

 

I eat most all foods listed high in B6 regularly, I'm surprised it's on the lower end.

 

I also do not want to lessen the effect of Levodopa.

 

Thanks,

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Hi Karen, good to hear from you. Lab values for plasma Vitamin B6 (Pyridoxal 5-Phosphate) generally range from around 5 - 24 ng/ml although different labs can have slightly different ranges. Unless your doctor has interpreted this lab value as low end, that would put you about in the middle, so I don't think there's a need to increase your level at this time. You're doing exactly the right thing in consuming foods rich in B6, because that is far, far less likely to block levodopa absorption. Let me know if this didn't adequately answer your question.

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Hi Kathrynne,

 

Sorry, I should have provided you with the range from the lab that is used in the first question.

 

The range they use is 5-50,

My Pcp says it is on the lower part of the range, but she will leave it up to my Nuero or MDS to decide if this is sufficient in pwp.

 

I thought I would check in with you first. I'm not sure they're on top of the nutritional piece as you. Seems I'm bringing them more info then I receive from them regarding nutrition.

 

Thanks again~

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OK, that does make a difference. First, did you ever have a baseline B6 established? I always encourage this, because it tells the doctor what your current level is, then a later test will show whether it has increased, decreased, or stayed the same. If your B6 has always been around this point, it could be an okay level for you.

 

However, if this is the first test, then this will be your baseline. As it's on the low end, let's look at the possibilities:

 

- You may require more B6, possibly because of PD or PD meds

 

- You may be USING more B6, possibly because of the nature of PD, age, lifestyle, or other factor.

 

- You might not be metabolizing B6 from food as well.

 

You're already eating foods rich in B6, so a supplement could be a good idea. Since the addition of carbidopa, most people can take up to 25 mg B6 daily without effect, although some people can be more sensitive and need to drop to 15 mg or even 10 mg. A solution here may be to take it at nighttime.

 

And, since B vitamins tend to support each other and work together, I would suggest a B-25 complex, except that, unhelpfully, manufacturers only provide B complex as B-50 or higher.

 

That being the case, I'd recommend a liquid such as:

 

Now Foods, B-12, Liquid, B-Complex, 8 fl oz so that you can take as much or as little as you like;

 

or Source Naturals, B-6, 50 mg, 250 Tablets, which you could split in half or smaller.

 

Also, if your doctor has not already done so, I would recommend a test for homocysteine. Here is some information that might be useful for your doctor:

 

 

 

Homocysteine, B vitamins, and Parkinson's disease
by Kathrynne Holden, MS, RD
Copyright 2008 - 2014

What is homocysteine?

    Homocysteine is an amino acid found in the bloodstream; it is naturally
produced  in small amounts by the human body from its precursor,
methionine. The body also removes homocysteine from the blood, using the B
vitamins folate, B12, and B6. An amount of homocysteine between 5 and 15
micromoles per liter of blood is considered normal; amounts greater than
that are considered "hyperhomocysteinemia" or elevated homocysteine.

Why is elevated homocysteine a problem?

    The relationship between homocysteine and diseases is not entirely
understood at this time. However, researchers have discovered that
homocysteine can prevent the formation of nitric oxide, a substance that
keeps blood vessels pliable and prevents formation of atherosclerosis.
Thus, homocysteine could be implicated in cardiovascular disease, strokes,
and heart attacks.

    Homocysteine may also be associated with memory impairment. In a study of
elderly individuals, elevated homocysteine was associated with cognitive
impairment (poorer ability to read, learn, remember, and understand) while
high levels of folate and vitamin B12 were associated with improved
cognition. Other researchers studied 1092 people aged 68 to 97, and found
that those whose homocysteine levels were over 14 micromoles per liter had
twice the risk of developing Alzheimer's disease as those with lower
levels.

        The findings are based on a study of 1,092 people from
68 to 97 who were initially healthy and free of dementia. Their
homocysteine levels were  measured and their health was monitored for
eight years. At the end of the study, 111 individuals had dementia,
including 83 with Alzheimer's. People whose homocysteine levels were
higher than 14 micromoles per liter of blood, one- fourth of the
participants, had nearly twice the Alzheimer's risk of those with lower
levels.

What about people with Parkinson's disease?

    Some scientists found that people with PD who had been using levodopa for
some time had higher levels of homocysteine than newly-diagnosed PD
patients who had not begun treatment with levodopa. In another study,
using mice, researchers found that on a low-folate diet the mice had
increased levels of homocysteine. They speculate that increased
homocysteine can worsen oxidative stress on the neurons that produce
dopamine, and make them more easily damaged by environmental toxins.

    Some degree of cognitive impairment, ranging from mild memory loss to
various types of dementias, is common among people with PD, more so than
in the general population. While not all cognitive impairment is related
to nutrient deficiency, some cases may well be, especially as people with
PD often change their eating habits in unsatisfactory ways.

    In an article "Homocysteine and Atherosclerotic Heart Disease: A New and
'Unusual Suspect,'" Michelle Taylor-Chinn writes:

    ..... clinicians are advised to assess fasting homocysteine levels only
in high-risk patients -- including those with arterial occlusive disease,
hypothyroidism, impaired kidney function, systemic lupus erythematosus, or
a significant family history of premature atherosclerosis. Elderly
patients should also be considered for testing, as should patients who
receive certain medications
or therapy (eg, theophylline, methotrexate,
levodopa, niacin [vitamin B3], nitrous oxide exposure). [Clinician Reviews
10(10):45-57, 2000. © 2000 Clinicians Publishing Group]
    
       Because many people with PD meet one or more of these risk factors
(i.e., age, use of levodopa, and possibly other conditions), I recommend
that you discuss testing for homocysteine with your physician. Older
people in particular may not absorb vitamin B12 sufficiently from food,
and should be assessed for possible deficiency. I also advise an eating
pattern that includes vegetables, whole-grain and fortified breads and
cereals, fruits, dried beans, peas, and lentils, and fish.

-- Kathrynne Holden, MS
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

O'Suilleabhain PE, Sung V, Hernandez C, Lacritz L, Dewey RB Jr,
Bottiglieri T, Diaz-Arrastia R.  Elevated plasma homocysteine level in
patients with Parkinson disease: motor, affective, and cognitive
associations. Arch Neurol. 2004 Jun;61(6):865-8.

Muller T, Renger K, Kuhn W. Levodopa-associated increase of homocysteine
levels and sural axonal neurodegeneration. Arch Neurol. 2004
May;61(5):657-60.

Sachdev P.  Homocysteine and neuropsychiatric disorders. Rev Bras
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Lokk J. Treatment with levodopa can affect latent vitamin B 12 and folic
acid deficiency. Patients with Parkinson disease runt the risk of elevated
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Teunissen CE, Lutjohann D, von Bergmann K, Verhey F, Vreeling F, Wauters
A, Bosmans E, Bosma H, van Boxtel MP, Maes M, Delanghe J, Blom HJ, Verbeek
MM, Rieckmann P, De Bruijn C, Steinbusch HW, de Vente J. Combination of
serum markers related to several mechanisms in Alzheimer's disease.
Neurobiol Aging. 2003 Nov;24(7):893-902.

Miller JW, Selhub J, Nadeau MR, Thomas CA, Feldman RG, Wolf PA. Effect of
L-dopa on plasma homocysteine in PD patients: relationship to B-vitamin
status. Neurology. 2003 Apr 8;60(7):1125-9.

McIlroy SP, Dynan KB, Lawson JT, Patterson CC, Passmore AP. Moderately
elevated plasma homocysteine, methylenetetrahydrofolate reductase
genotype, and risk for stroke, vascular dementia, and Alzheimer disease in
Northern Ireland. Stroke. 2002 Oct;33(10):2351-6.
    
Herrmann W, Knapp JP. Hyperhomocysteinemia: a new risk factor for
degenerative diseases. Clin Lab 2002;48(9-10):471-81.

Kelly PJ, Furie KL. Management and Prevention of Stroke Associated with
Elevated Homocysteine. Curr Treat Options Cardiovasc Med 2002
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Kelly PJ, Rosand J, Kistler JP, Shih VE, Silveira S, Plomaritoglou A,
Furie KL. Homocysteine, MTHFR 677C-->T polymorphism, and risk of ischemic
stroke: results of a meta-analysis. Neurology 2002 Aug 27;59(4):529-36.

Cindy J. Warren CJ. Emergent Cardiovascular Risk Factor: Homocysteine.
Prog Cardiovasc Nurs 17(1):35-41, 2002.

 


Karen, I hope this is helpful, let us know how you're doing and what your doctor advises.

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I will share this with info with my MDS. It was my first B6 test, therefore, it is my baseline....l

 

In May of 2013 my B12 was 1,288. The normal levels are 207-974.

I was taking a B12 supplement, but stopped due to the high count.

 

I'll keep you posted.

 

Thank you Kathrynne!

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This is good, you have a baseline for both B6 and B12. As your B12 was high, you might try just B6. Solgar makes a 25 mg B6, which you could split in half if you choose. Then, whenever your doctor suggests, you could have another test run (and include B12) to see if your levels have changed. You are doing exactly the right thing in being proactive and in seeking information to make the best possible decision. Indeed, please do keep us posted.

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