Folinic acid vitamin b12
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The Role of Folinic Acid and Vitamin B12 in Health and Disease
Folinic Acid and Vitamin B12 in Hematologic Toxicity Prevention
Research has explored the potential of folinic acid and vitamin B12 supplementation to mitigate the hematologic toxicity induced by zidovudine (ZDV) in HIV-infected patients. A study involving 75 patients found that while supplementation increased vitamin B12 and folate levels, it did not significantly impact hemoglobin, hematocrit, or white-cell counts. Severe hematologic toxicity occurred in both the supplemented and non-supplemented groups, indicating that folinic acid and vitamin B12 may not effectively prevent ZDV-induced myelotoxicity in the general population.
Hyperhomocysteinemia Management in Hemodialysis Patients
Hyperhomocysteinemia, a common condition in hemodialysis patients, is a risk factor for cardiovascular disease. Studies have shown that high doses of folic acid, vitamin B6, and vitamin B12, as well as intravenous folinic acid, do not significantly lower total homocysteine (tHcy) levels in these patients. Despite increased plasma folate and vitamin B12 levels, the interventions did not result in significant changes in tHcy, suggesting limited efficacy of these supplements in managing hyperhomocysteinemia in hemodialysis patients.
Cancer Risk Associated with Folic Acid and Vitamin B12 Supplementation
Long-term supplementation with folic acid and vitamin B12 has been linked to an increased risk of cancer, particularly colorectal cancer. The B-PROOF trial, which followed participants for 2 to 3 years, found a higher incidence of overall cancer and colorectal cancer in those receiving the supplements compared to a placebo group. These findings suggest that folic acid and vitamin B12 supplementation may elevate cancer risk, warranting further investigation and cautious use of these supplements.
Impact on Glycemic Control in Type 2 Diabetes
In patients with type 2 diabetes, supplementation with vitamin B12 and folic acid has shown promising results in improving glycemic control and insulin resistance. A clinical trial demonstrated significant reductions in HbA1c levels and improvements in plasma insulin and insulin resistance in patients receiving these supplements. However, no significant changes were observed in the lipid profile, indicating that the benefits may be specific to glycemic parameters.
Cognitive Function and Dementia
The effects of folic acid and vitamin B12 on cognitive function and dementia have been extensively studied. While some trials have shown no significant cognitive benefits from these supplements in healthy or cognitively impaired elderly individuals, others have reported improvements in specific subgroups. For instance, folic acid supplementation was associated with better cognitive function in elderly individuals with high homocysteine levels. However, the overall evidence remains inconclusive, highlighting the need for more research .
Fetal Development and Pregnancy
Folic acid and vitamin B12 play crucial roles in fetal development, particularly in reducing the incidence of intrauterine growth retardation and improving placental function. Supplementation during pregnancy has been shown to enhance placental antioxidant capacity, angiogenesis, and amino acid transport, leading to better fetal outcomes. These findings underscore the importance of adequate folic acid and vitamin B12 intake during pregnancy for optimal fetal development.
Developmental Benefits in Children
In young children, deficiencies in vitamin B12 and folic acid are linked to delayed development and neurological issues. A study in North Indian children found that daily supplementation with both vitamins significantly improved gross motor and problem-solving skills, especially in children with high plasma homocysteine levels or those who were stunted. This suggests that combined supplementation can be beneficial for child development in populations at risk of deficiencies.
Homocysteine Levels in Hemodialysis Patients
In hemodialysis patients, intravenous supplementation with pharmacological doses of vitamin B12 alone has been found to be as effective as low-dose folinic acid in reducing plasma homocysteine levels. Combining both supplements may offer additional benefits, indicating that vitamin B12 can play a significant role in managing hyperhomocysteinemia in these patients.
Conclusion
Folinic acid and vitamin B12 have diverse roles in health and disease management, from preventing hematologic toxicity and managing hyperhomocysteinemia to improving glycemic control and supporting fetal development. However, their supplementation must be approached with caution due to potential risks, such as increased cancer incidence. Further research is essential to fully understand their benefits and limitations in various health conditions.
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