Health
Dementia risk could increase with low levels of essential vitamin
“Normal” levels of vitamin B12 may not be enough to ward off dementia, new research finds.
Researchers at University of California San Francisco studied 231 healthy older adults (averaging 71 years of age) who did not have dementia or mild cognitive impairment.
Blood tests showed that their B12 levels averaged 414.8 pmol/L, while the recommended minimum level in the U.S. is just 148 pmol/L.
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Participants who had lower B12 levels were found to have “slower cognitive and visual processing speeds” when taking tests, which is linked to “subtle cognitive decline,” according to a UCSF press release.
The effect was more pronounced with age.
“Normal” levels of vitamin B12 may not be enough to ward off dementia, new research finds. (iStock)
The people with lower levels also had more lesions in the white matter in their brains, which can be a warning sign of cognitive decline, dementia or stroke, the researchers found.
The findings were published in Annals of Neurology on Feb. 10.
Based on these results, the researchers recommend updating the current B12 requirements.
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“Previous studies that defined healthy amounts of B12 may have missed subtle functional manifestations of high or low levels that can affect people without causing overt symptoms,” said senior author Ari J. Green, MD, of the UCSF Departments of Neurology and Ophthalmology and the Weill Institute for Neurosciences.
“Revisiting the definition of B12 deficiency to incorporate functional biomarkers could lead to earlier intervention and prevention of cognitive decline.”
“Revisiting the definition of B12 deficiency to incorporate functional biomarkers could lead to earlier intervention and prevention of cognitive decline.” (iStock)
The researchers did acknowledge that the study only included older adults, who may have a “specific vulnerability” to lower levels of B12.
Those lower levels, however, “could impact cognition to a greater extent than what we previously thought, and may affect a much larger proportion of the population than we realize,” according to co-first author Alexandra Beaudry-Richard, who is currently completing her doctorate in research and medicine at the UCSF Department of Neurology and the Department of Microbiology and Immunology at the University of Ottawa.
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“In addition to redefining B12 deficiency, clinicians should consider supplementation in older patients with neurological symptoms even if their levels are within normal limits,” she suggested in the release.
“Ultimately, we need to invest in more research about the underlying biology of B12 insufficiency, since it may be a preventable cause of cognitive decline.”
“Even participants with B12 levels deemed ‘normal’ by today’s medical standards showed clear signs of neurological impairment.”
Dr. Brett Osborn, a Florida neurosurgeon and longevity expert, said the study supports the idea that “normal” vitamin B12 levels are “grossly inadequate” for protecting the brain from age-related decline.
“Even participants with B12 levels deemed ‘normal’ by today’s medical standards showed clear signs of neurological impairment — slower processing speeds, increased white matter hyperintensities on MRI (a marker of small vessel disease), and elevated tau protein (a biomarker of neurodegeneration). This is concerning to say the least,” Osborn told Fox News Digital.
The current minimum recommendations weren’t designed for optimal cognitive function or longevity, according to Osborn.
One neurosurgeon and longevity expert recommends supplements of B-complex vitamins, including B12, to ensure healthy levels of homocysteine, an amino acid that is produced during protein metabolism. (iStock)
“Instead, they were based on population averages — an inherently flawed approach when the ‘average’ person today is metabolically unhealthy. This is yet another example of mainstream medicine lagging behind the science.”
In Osborn’s clinic, he recommends supplements of B-complex vitamins, including B12, to ensure healthy levels of homocysteine, an amino acid that is produced during protein metabolism.
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“When homocysteine is elevated — a potential proxy for low B12 — brain function declines,” Osborn said.
The doctor did note that the study is observational, and that “correlation doesn’t prove causation.”
“Even participants with B12 levels deemed ‘normal’ by today’s medical standards showed clear signs of neurological impairment.” (iStock)
“But do you really need a randomized controlled trial to tell you that optimizing B12 intake benefits brain health? That’s like waiting for a study to confirm that eating vegetables is good for you,” Osborn said.
“The data are there. The science is crystal-clear.”
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Like the researchers, Osborn called for an update to the “normal” lab levels.
“It’s time to start defining health by optimal levels — not by whatever happens to be ‘average’ in an increasingly sick population. Because who wants to be normal when you can be optimal?”
“No clear evidence has been found to suggest benefit in B12 supplementation in patients without a deficiency.”
Dr. Earnest Lee Murray, a board-certified neurologist at Jackson-Madison County General Hospital in Jackson, Tennessee, agreed that this study raises the question of redefining what levels constitute a B12 deficiency.
“Previous studies have recommended supplementation in patients with a known vitamin B12 deficiency to mitigate cognitive issues; however, no clear evidence has been found to suggest benefit in B12 supplementation in patients without a deficiency,” Murray, who was not involved in the study, told Fox News Digital.
The neurologist cautioned against people taking “mega-doses” of vitamins.
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“Often, high levels of vitamins, especially B12, won’t cause issues; however, it can happen,” Murray said.
“I would recommend that patients who are older or at risk of developing cognitive decline discuss with their physician about being tested — not just for vitamin B12 levels, but also for other markers that could suggest improper absorption of vitamin B12.”
Health
Brain Health Challenge: Workouts to Strengthen Your Brain
Today, you’re going to do perhaps the single best thing for your brain.
When I asked neurologists about their top behaviors for brain health, they all stressed the importance of physical activity.
“Exercise is top, No. 1, when we’re thinking about the biggest bang for your buck,” said Dr. Gregg Day, a neurologist at the Mayo Clinic.
Numerous studies have shown that people who exercise regularly tend to perform better on attention, memory and executive functioning tests. There can be a small cognitive boost immediately after a workout, and the effects are sustained if people exercise consistently. And while staying active can’t guarantee you won’t develop dementia, over the long term, it is associated with a lower risk of it.
Researchers think that moving your muscles benefits your brain in part because of special signaling molecules called exerkines. During and after a workout, your muscles, fat and other organs release these molecules into the bloodstream, some of which make their way up to the brain. There, those exerkines go to work, helping to facilitate the growth of new connections between neurons, the repair of brain cells and, possibly, the birth of new neurons.
Exercise also appears to improve blood flow in the brain. That ramps up the delivery of good things to brain cells, like oxygen, glucose and those amazing exerkines. And it helps remove more bad things, namely toxic proteins, like amyloid, that can build up and damage brain cells, increasing the risk for Alzheimer’s.
All of the changes brought on by exercise are “essentially allowing your brain to age more slowly than if you’re physically inactive,” said Kirk Erickson, the chair of neuroscience at the AdventHealth Research Institute.
The benefits are particularly pronounced in the hippocampus, a region critical for learning and memory. In older adults, the hippocampus shrinks 1 to 2 percent a year, and it is one of the main areas affected by Alzheimer’s. Researchers think physical activity helps to offset some of that loss.
The best exercise you can do for your brain is the one you’ll do consistently, so find something that you enjoy and that fits easily into your life.
Walking is one option; two neurologists I spoke to said they got their exercise in by walking at least part of the way to their offices. Recent research suggests that just a few thousand steps a day can reduce the risk of dementia. It’s important to get your heart rate up, though, so “walk as though you’re trying to get somewhere on time,” said Dr. Linda Selwa, a clinical professor of neurology at the University of Michigan Medical School.
Or you could try swimming, cycling, Pilates, weight lifting, yoga, pickleball, dancing, gardening — any type of physical exertion can be beneficial.
If the thought of working out feels like a drag, try pairing it with something else you enjoy doing, like listening to an audiobook. This is a trick that Katherine Milkman, a professor who studies habits at The Wharton School of the University of Pennsylvania, calls “temptation bundling.”
For Day 3, we’re asking you to spend at least 20 minutes exercising for your brain. Go for a walk with your accountability partner if they’re nearby. (If not, call them and do a walk-and-talk.) Or let us find you a new workout to try, using the tool below. As usual, we can all meet in the comments to catch up and check in.
Health
Little-known prescription pill is helping Americans drink less alcohol
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Recent studies continue to support a decades-old drug as an alternative means of reducing alcohol consumption.
The prescription opioid pill, called naltrexone, was first approved by the FDA to treat opioid dependence in 1984. A decade later, it was approved for alcohol use disorder.
In addition to the daily pill version, naltrexone is also available as a monthly injectable therapy, which was approved for alcohol use disorder in 2006 and opioid use disorder in 2010.
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How it works
Naltrexone works by blocking opioid receptors in the brain. For those dependent on opioids, it blocks the “euphoric” effects of the drugs and also curbs cravings for alcohol, according to experts.
The prescription opioid pill, called naltrexone, was first approved by the FDA to treat opioid dependence in 1984. A decade later, it was approved for alcohol use disorder. (iStock)
“Naltrexone can be used to assist with reducing alcohol cravings and reduce the pleasurable effects from alcohol ingestion, which can help those prone to binge-drinking to consume less volume,” Dr. David Campbell, clinical director and program director at Recover Together, a behavioral health and addiction treatment facility in Bend, Oregon, told Fox News Digital.
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The medication is useful for people who experience strong cravings, often drink to excess once they start, or drink primarily due to reward or relief as opposed to habit, according to Campbell.
“Naltrexone affects the rewards center of the brain, which blocks the rewarding effects of alcohol.”
Jessica Steinman, chief clinical officer at No Matter What Recovery in Los Angeles, calls naltrexone “an incredibly helpful and life-saving tool” for people who struggle with alcohol use disorder.
“Currently, in our society, many people are looking to get medication-assisted help from overconsumption of certain things or behaviors, including food, cigarettes and now alcohol,” she told Fox News Digital.
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“Naltrexone affects the rewards center of the brain, which blocks the rewarding effects of alcohol and cravings to be minimized. It can assist in telling the brain that alcohol isn’t wanted.”
The drug can also help if someone has a “healthy” relationship with alcohol and is looking to cut back on their drinking behaviors, Steinman added.
“We do not suggest moderation in any way for people struggling with alcohol use disorder or any type of dependence to alcohol or other substances,” she noted. “We do not believe drinking ‘less’ is a solution.”
Side effects
Common side effects of naltrexone can include nausea and vomiting, headache, sleep disturbances, dizziness, fatigue, anxiety, loss of appetite, and joint or muscle pain, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
These effects are generally mild and may improve as the body adjusts to the medication.
The medication is useful for people who experience strong cravings, often drink to excess once they start, or drink primarily due to reward or relief as opposed to habit. (iStock)
In rare cases, patients may experience more severe effects, such as liver issues, allergic reactions, trouble breathing and mental health effects.
“The most important thing when taking naltrexone for alcohol use is to ensure that there is no concurrent use of opioids, as taking naltrexone when using opioids can induce precipitated withdrawal, a very uncomfortable event,” Campbell cautioned.
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More than 50% of U.S. adults drink alcohol, about 17% are classified as binge-drinkers and about 6% drink heavily, according to CDC data.
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Each year, around 178,000 deaths in the country are linked to excessive alcohol use.
“Heavy alcohol consumption and binge-drinking can lead to many health problems and make chronic health conditions worse, so reducing alcohol intake can really improve health,” Donita Robinson, Ph.D., an associate professor of psychiatry at the UNC School of Medicine in North Carolina, told Fox News Digital.
More than 50% of U.S. adults drink alcohol, about 17% are classified as binge-drinkers and about 6% drink heavily. (iStock)
“Naltrexone helps many people reduce their drinking – it’s an effective medication to reduce alcohol craving and heavy drinking, and it works best in combination with counseling or other therapy.”
Robinson reiterated that people who are on opioid medications, including some painkillers, shouldn’t take naltrexone, as it can block their effectiveness and cause opioid withdrawal.
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Naltrexone is available with a prescription from a licensed healthcare provider, such as a primary care doctor, addiction medicine specialist or psychiatrist.
Health officials warn against purchasing the drug online or without a prescription, as it may be counterfeit and unsafe.
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Those interested in exploring whether naltrexone is an option for them should see a doctor, who can assess the safety of the drug based on the patient’s medical status and history.
They should also “make sure they have their goals and intentions in line before using a medication like this,” according to Steinman.
Health
Brain Health Challenge: Try the MIND Diet
Welcome to Day 2 of the Brain Health Challenge. Today, we’re talking about food.
Your brain is an energy hog. Despite comprising about 2 percent of the average person’s body mass, it consumes roughly 20 percent of the body’s energy. In other words, what you use to fuel yourself matters for brain health.
So what foods are best for your brain?
In a nine-year study of nearly 1,000 older adults, researchers at Rush University in Chicago found that people who ate more of nine particular types of food — berries, leafy greens, other vegetables, whole grains, beans, nuts, fish, poultry and olive oil — and who ate less red meat, butter and margarine, cheese, sweet treats and fried food had slower cognitive decline.
Based on these findings, the researchers developed the MIND diet.
Large studies encompassing thousands of people have since shown that following the MIND diet corresponds with better cognitive functioning, a lower risk of dementia and slower disease progression in people with Alzheimer’s. People benefit from the diet regardless of whether they start it in midlife or late life.
Experts think the foods included in the MIND diet are especially good for the brain because they contain certain macro and micronutrients.
Berries and leafy greens, for example, are rich in polyphenols and other antioxidants, said Jennifer Ventrelle, a dietitian at Rush and a co-author of “The Official Mind Diet.” Many of these compounds can cross the blood-brain barrier and help to fight inflammation and oxidative stress, both of which can damage cells and are linked to dementia.
Nuts and fatty fishes, like salmon and sardines, contain omega-3 fatty acids, which are important for building the insulating sheaths that surround the nerve fibers that carry information from one brain cell to another.
Whole grains and beans both contain a hefty dose of fiber, which feeds the good microbes in the gut. Those microbes produce byproducts called short-chain fatty acids that experts think can influence brain health via the gut-brain axis.
You don’t have to revamp your whole diet to get these nutrients. Instead, think about “MIND-ifying” whatever you already tend to eat, said Dr. Joel Salinas, a neurologist at NYU Langone Health and the founder and chief medical officer of the telehealth platform Isaac Health. For instance, add a handful of nuts or berries to your breakfast.
Today’s activity will help you MIND-ify your own meals. Share your choices with your accountability partner and in the comments, and I’ll discuss the ways I’m adjusting my diet, too. For added inspiration, check out these MIND-approved recipes from New York Times Cooking.
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