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June 8, 2010

Increased intake of vitamins B6 and B12 from food and supplements linked to less depression

Increased intake of vitamins B6 and B12 from food and supplements linked to less depression

A report published online on June 2, 2010 in the American Journal of Clinical Nutrition reveals a lower risk of developing depression among men and women who consume greater amounts of vitamin B6 and vitamin B12.

Researchers at Rush University Medical Center in Chicago evaluated data from 3,503 participants in the Chicago Health and Aging project, an ongoing study of adults aged 65 and older. Intake of vitamin B6, vitamin B12 and folate was calculated from dietary questionnaire responses. Depression was assessed via the 10 item Center for Epidemiologic Studies Depression scale administered during follow-up interviews conducted between 1997 and 2009.

Four hundred seventy-one participants reported at least 4 depressive symptoms over up to 12 years of follow-up. Adjusted analysis of the data revealed that higher intakes of both vitamin B6 and B12 from food and supplements were associated with decreased depressive symptoms over the course of follow-up. Each additional 10 milligrams of vitamin B6 and 10 micrograms of vitamin B12 intake were associated with a 2% lower risk of developing depressive symptoms per year. No significant benefit was observed in association with B vitamin intake from food alone, nor was an effect found for folate. The authors note that vitamin B12 from food sources has poor bioavailability and absorption, especially in older individuals. They also suggest that "it is possible that folate is associated with the onset of depressive symptoms but only at insufficient concentrations that are below the range of intake that occur in fortified folic acid populations such as the Chicago Health and Aging Project population."

In their discussion of possible protective mechanisms for the vitamins against depression, the authors remark that a deficiency of vitamin B12 is responsible for a neurological syndrome that includes depressive symptoms, and that pyridoxal 5'-phosphate, the primary biologic form of vitamin B6, is a cofactor in serotonin synthesis, a neurotransmitter that has an important role in mood.

"Our results support the hypotheses that high total intakes of vitamins B6 and B12 are protective of depressive symptoms over time in community-residing older adults," Kimberly A. Skarupski and her colleagues conclude. "In the assessment and treatment of depressive symptoms in older adults, clinicians and other health care professionals should be mindful of the patient’s nutritional status in general, and whether there are vitamin insufficiencies in these nutrients before treatment."

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Health Concern Life Extension Highlight

Depression

Serotonin and norepinephrine are neurotransmitters that regulate mood, sleep, appetite, and emotion and are involved in a variety of physiological and behavioral functions. If the immediate reuptake of serotonin (or norepinephrine) is prevented, more of these precious brain chemicals remain available to do their intended work (Vaswani M et al 2003; Bourin M et al 2002).

Many nutrients and supplements can influence the body’s management of vital neurotransmitters. Much like the prescription drugs used to treat depression, these natural therapies act by increasing production of neurotransmitters or reducing their rates of degradation. Unlike prescription drugs, however, natural therapies can also minimize the effects of oxidative stress and inflammation that contribute to depression.

One intriguing target for therapy is homocysteine, which is an intermediary amino acid that has been associated with various disease states. Studies have shown that elevated homocysteine is also associated with depressive disorders and anger attacks caused by depression (Chen CS et al 2005). Homocysteine levels can be lowered by the following nutrients, some of which (especially S-adenosyl-L-methionine, or SAMe) have been found to improve depression independently.

Folic acid. Clinical trials have demonstrated that folic acid relieves depression on its own and enhances the antidepressant effect of conventional antidepressants. In one study, patients given 500 mcg folic acid daily in conjunction with fluoxetine experienced a significant improvement in depressive symptoms compared with patients receiving the antidepressant alone, and women benefited particularly (Coppen A et al 2000). Because relapse is associated with low serum folate, it is important to maintain folate supplementation for a year following a depressive episode (Morris MS et al 2003).

Vitamin B12 (cobalamin). Deficiency in vitamin B12 has been cited as a risk factor for developing depression (Gottfries CG 2001) and is associated with increased homocysteine (Parnetti L et al 1997; Stabler SP et al 1990). People with high vitamin B12 levels have better treatment outcomes for major depression (Hintikka J et al 2003). Vitamin B12 supplementation is important for depressed individuals, particularly older patients, in whom low vitamin B12 levels are common (Lindeman RD et al 2000; Penninx BW et al 2000).

Vitamin B6 (pyridoxine). In 2005, a team of researchers from Yale University examined all the published studies on vitamin B6 and depression. Although the researchers did not find evidence of benefits from vitamin B6 treatment in the results of all the studies, they did find that premenopausal women suffering from depression benefited from vitamin B6 (Williams AL et al 2005).

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