Can you take vitamin b12 and folic acid together
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Can You Take Vitamin B12 and Folic Acid Together?
Combined Supplementation of Vitamin B12 and Folic Acid: Overview
Taking vitamin B12 and folic acid together is a common practice due to their synergistic roles in various metabolic processes. Research indicates that combined supplementation can have several health benefits, particularly in reducing homocysteine levels, which is a risk factor for cardiovascular diseases and other health conditions1 4 5.
Cardiovascular Health Benefits
Reduction in Homocysteine Levels
Several studies have shown that combined supplementation of folic acid and vitamin B12 can significantly reduce homocysteine levels. Elevated homocysteine is associated with an increased risk of cardiovascular diseases. A meta-analysis of randomized control trials found that taking folic acid with vitamin B12 and B6 reduced homocysteine levels by 2.53 µmol/L1. Another study confirmed that long-term combined treatment with folic acid, vitamin B6, and vitamin B12 lowered homocysteine concentrations by 18%4.
Impact on Cardiovascular Events
While the reduction in homocysteine levels is clear, the direct impact on cardiovascular events such as myocardial infarction and stroke is mixed. The meta-analysis indicated that combined supplementation did not significantly affect the incidence of cardiovascular disease events or myocardial infarction but did reduce the risk of stroke by 14%1. This suggests that while the overall cardiovascular benefits might be limited, there is a specific protective effect against stroke.
Metabolic and Cognitive Benefits
Glycemic Control and Insulin Resistance
In patients with type 2 diabetes, combined supplementation of folic acid and vitamin B12 has shown promising results in improving glycemic control and reducing insulin resistance. A clinical trial reported significant improvements in HbA1c levels, plasma insulin, and insulin resistance in groups receiving both vitamins compared to standard treatment3.
Cognitive Function and Inflammation
For elderly individuals with mild cognitive impairment, combined supplementation of folic acid and vitamin B12 has been found to improve cognitive performance and reduce levels of inflammatory cytokines. This suggests potential benefits in preventing or slowing cognitive decline and reducing inflammation-related damage in the brain7.
Developmental Benefits in Children
Motor and Cognitive Development
In young children, combined supplementation of vitamin B12 and folic acid has been associated with improvements in gross motor and problem-solving skills. A study conducted in North India found that children receiving both vitamins showed significant developmental gains compared to those receiving a placebo9. This highlights the importance of these vitamins in early childhood development.
Potential Risks and Considerations
Cancer Risk
Despite the numerous benefits, there are potential risks associated with long-term supplementation. A study from the B-PROOF trial indicated that combined supplementation of folic acid and vitamin B12 might be associated with an increased risk of colorectal cancer8. This finding suggests that while supplementation can be beneficial, it should be approached with caution, particularly in populations at risk for cancer.
Conclusion
In summary, taking vitamin B12 and folic acid together can offer several health benefits, including reduced homocysteine levels, improved glycemic control, enhanced cognitive function, and better developmental outcomes in children. However, potential risks such as an increased cancer risk should be considered. As always, it is advisable to consult with a healthcare provider before starting any new supplementation regimen.
Sources and full results
Most relevant research papers on this topic
[Meta-analysis on effect of combined supplementation of folic acid, vitamin B12 and B6 on risk of cardio-cerebrovascular diseases in randomized control trials].
Taking folic acid, vitamin B6, and B12 combined may not significantly affect cardiovascular disease risk, but may lower stroke risk and homocysteine levels.
Meta-AnalysisCombined biotin, folic acid, and vitamin B12 supplementation given during the transition period to dairy cows: Part I. Effects on lactation performance, energy and protein metabolism, and hormones.
Combined biotin, folic acid, and vitamin B12 supplementation during the transition period improves lactation performance, energy and protein metabolism, and hormones in dairy cows.
RCT
Rigorous JournalFolic acid and vitamin B12 supplementation in subjects with type 2 diabetes mellitus: A multi-arm randomized controlled clinical trial.
Add-on supplementation with vitamin B12 improved glycemic control and insulin resistance in patients with type 2 diabetes mellitus, but not lipid profile.
RCTEffect of Combined Treatment With Folic Acid, Vitamin B6, and Vitamin B12 on Plasma Biomarkers of Inflammation and Endothelial Dysfunction in Women
Long-term combined treatment with folic acid, vitamin B6, and vitamin B12 lowers homocysteine levels but does not alter major biomarkers of vascular inflammation in women at increased risk of cardiovascular disease.
RCT
Large Human TrialRigorous JournalA Combined Supplementation of Omega-3 Fatty Acids and Micronutrients (Folic Acid, Vitamin B12) Reduces Oxidative Stress Markers in a Rat Model of Pregnancy Induced Hypertension
Combined supplementation of folic acid, vitamin B12, and omega-3 fatty acids reduces oxidative stress and inflammation in a rat model of pregnancy-induced hypertension.
RCT
Animal StudyRigorous JournalEffects of intramuscular injections of folic acid, vitamin B12, or both, on lactational performance and energy status of multiparous dairy cows.
Folic acid supplementation in multiparous dairy cows improves energy partitioning in early lactation, resulting in similar milk yield and postpartum energy balance, lower nonesterified fatty acid concentration, and higher plasma glucose and insulin concentrations.
Non-RCTAnimal StudyRigorous JournalEffects Of Folic Acid And Vitamin B 12 , Alone and in Combination on Cognitive Function and inflammatory Factors in the Elderly with Mild Cognitive Impairment: A Single-Blind Experimental Design.
The combination of oral folic acid and vitamin B 12 significantly improves cognitive performance and reduces inflammatory cytokines in elderly with mild cognitive impairment, making it a superior treatment option.
RCTFolic Acid and Vitamin B12 Supplementation and the Risk of Cancer: Long-term Follow-up of the B Vitamins for the Prevention of Osteoporotic Fractures (B-PROOF) Trial
Folic acid and vitamin B12 supplementation may increase the risk of colorectal cancer.
RCTLarge Human TrialVitamin B12 and Folic Acid Improve Gross Motor and Problem-Solving Skills in Young North Indian Children: A Randomized Placebo-Controlled Trial
Daily supplementation with vitamin B12 and folic acid improves gross motor and problem-solving skills in young North Indian children, with higher effects in susceptible subgroups.
RCTLarge Human TrialRigorous JournalVitamin B12, folic acid, and the nervous system
Vitamin B12 and folic acid deficiencies together play crucial roles in nervous system function and may help prevent disorders like CNS development, mood disorders, and dementias.
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