Folic acid and vitamin b6 supplementation
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Folic Acid and Vitamin B6 Supplementation: Effects on Homocysteine and Cardiovascular Health
Research shows that folic acid supplementation, either alone or combined with vitamin B6, can lower plasma homocysteine levels, which are linked to cardiovascular risk. In healthy young women, folic acid supplementation reduced homocysteine by 11.5%, and the combination with vitamin B6 led to a 17% reduction. However, vitamin B6 alone did not have a significant effect on homocysteine levels within the normal range .
Meta-analyses indicate that combined supplementation with folic acid, vitamin B6, and vitamin B12 can significantly reduce the risk of stroke, especially in areas without or with only partial folic acid fortification. The most effective dosages for stroke prevention appear to be folic acid ≤0.8 mg/day and vitamin B12 ≤0.4 mg/day. However, these combinations do not significantly reduce the risk of other cardiovascular events or myocardial infarction 25. Some evidence suggests that moderate doses of vitamin B6 (5–10 mg/day) combined with folic acid may reduce the risk of coronary revascularization, but higher doses of folic acid do not provide additional benefit and may even increase risk .
Supplementation and Inflammation in Diabetic Neuropathy
In patients with diabetic neuropathy, co-supplementation of folic acid, vitamin B6, and vitamin B12 significantly decreased inflammation, as measured by serum Hs-CRP levels. This suggests a potential benefit for reducing inflammation in this population .
Effects on Pregnancy Outcomes
For women with a history of preeclampsia or fetal growth restriction and hyperhomocysteinemia, supplementation with folic acid and vitamin B6 normalized methionine metabolism and was associated with improved perinatal outcomes, including higher birth weights in subsequent pregnancies .
Cognitive Function and Depression
Multiple studies and systematic reviews have found that supplementation with folic acid and vitamin B6, alone or in combination with vitamin B12, does not improve cognitive function or reduce the risk of cognitive impairment or dementia in older adults 89. Similarly, long-term, high-dose supplementation did not reduce the risk of depression in older women, despite lowering homocysteine levels .
Bone Health and Fracture Risk
Long-term supplementation with folic acid, vitamin B6, and vitamin B12 does not reduce the risk of nonspine fractures or affect bone turnover markers in middle-aged and older women at high risk of cardiovascular disease .
Conclusion
Folic acid and vitamin B6 supplementation, especially when combined with vitamin B12, can lower homocysteine levels and reduce stroke risk, particularly in populations without widespread folic acid fortification. There is also evidence for reduced inflammation in diabetic neuropathy and improved pregnancy outcomes in women with certain risk factors. However, these supplements do not appear to benefit cognitive function, depression risk, or bone health in older adults. The most consistent benefits are seen in homocysteine reduction and stroke prevention, with optimal effects at moderate dosages.
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