I feel compelled to do a post today in response to medical news that
is all over the news wires today about statin drugs, that's the class
of drugs that lower your cholesterol levels. The LA Times Headline
says "about 70 million Americans could take statins under new
guidelines"
Let me just read the first few paragraphs of the article,
"The number of Americans taking cholesterol-lowering statin drugs is
set to double under new guidelines unveiled Tuesday by the American
College of Cardiology and the American Heart Assn.
The goal of prescribing statins to as many as 70 million people is to
reduce the incidence of heart attacks and strokes in the United
States, not merely to get patient's LDL cholesterol – the "bad" kind
that's most closely linked to disease risk – into an ideal range,
experts said.
The new game plan for statins represents a stark shift from approaches
embraced by cardiologists and primary care physicians for most of the
past decade. Now, doctors will be urged to treat a wider range of
healthier patients, including those likely to suffer stroke or heart
disease as they age.
The new guidelines distinguish between patients who would benefit most
from high-dose statin therapy and those who can take a lower dose less
likely to cause side effects, such as muscle fatigue, a slight rise in
blood sugar and, in rare cases, hemorrhagic strokes and a toxic
breakdown of muscle tissue called rhabdomyolysis.
Cholesterol is essential for digestion, hormonal balance and cell
function, but at high concentrations can gum up arteries. Statins
reduce cholesterol by blocking the liver's production of the waxy
substance. Americans spent $21.3 billion on cholesterol-lowering
medications in 2010, including statins marketed under such brand names
as Crestor, Lipitor and Zocor.
Under the new guidelines, physicians should prescribe statin
medications to all patients with high odds of suffering a heart attack
or stroke in the short-term — that is, those who have had such an
event already, patients with Type 2 diabetes, and those with
exceptionally high levels of LDL cholesterol linked to familial risk.
But the guidelines also recommend that patients with a 7.5% risk of
suffering a stroke or heart attack over the next decade be prescribed
statin medication as well."
Not surprising the Wall Street Journal reports "AstraZeneca Applauds
the Release of New US Guideline for Management of Blood Cholesterol"
It's not surprising because according to WebMD AstraZeneca's Crestor
was the number 1 most prescribed drug last year with 23.7 million
prescriptions and total sales of $5.3 billion dollars. These new
guidelines are expected to double the number of prescriptions for the
statin drug class having a major positive impact on AstraZeneca's
bottom line.
Another amazing development, in a story reported in Endocrinology
Update on Nov 4 past American Medical Association president Professor
Kerryn Phelps advised the public via her Twitter account to consider
stopping their statins. She twitted her comment while watching ABCs
series called Heart of the Matter Part 2: Cholesterol Drug War which
claimed that the medical profession and the public had been duped into
believing that statins were essential for preventing death from heart
disease.
One of the studies that they used to come up with these guidelines is
a meta analysis by the Cochrane group that added up results from 18
different trials to conclude that statins reduced deaths from all
causes in people with low risk of heart disease. Their conclusion was
that if 1000 people took a statin over 5 years, 18 of them would avoid
a major cardiovascular event. The British Medical Journal in October
of this year argues that the "events" in the trials included
procedures to improve blood flow to the heart and who knows if the
person would have had a heart attack if this hadn't been done? It also
says that the side-effects of statins such as increased risk of
developing diabetes (about 10%) and muscle pain (50% more common) were
not adequately reported. It further points out that all of the
randomized trials in the Cochrane review were funded by the
manufacturers of the statins being studied. Interestingly, another
Cochrane review unrelated to this story showed that industry-sponsored
studies are more likely to find positive results than non-commercial
trials.
Let me review with you some articles that have been published in the
last few months about the risks associated with statins.
Oct 25, 2013 the Men's Journal had an article called Statin's Latest
Side Effects. In this article they pointed out that in a trial of more
than 46,000 adults, statin users had a 27 percent greater risk of
developing vision-skewing conditions than non users. According to Dr
Daniel Briceland, spokesperson for the American Academy of
Ophthalmology "The lens epithelial cells are very sensitive to changes
in oxidative stress" Since statins interfere with oxidation processes
the eye cells might not regenerate properly to clear away cataracts.
According to Dr Paul Thompson, chief of cardiology at Harvard Hospital
in Connecticut, "We know that statins inhibit a process that dissolves
collagen and other fibrous tissue, so it could be that this interferes
with the eye's ability to repair damaged tissue."
According to the Chicago Tribune Oct 30, 2013, when Mevacor also known
as lovastatin, the first statin drug, was being developed, animal
studies suggested that cataracts might be a side effect. On May 21,
2010 a British study reported in the British Medical Journal online
showed that statins increased the risk of cataracts and the risk
returned to normal within a year of stopping the statin medication.
A new study reported in JAMA Ophtamology online on Sept 19, 2013
showed that cataracts are more common in statin users than non users.
Diabetes, according to Renal and Urology News, atrovastin had no
significant affect on a combined endpoint of cardiovascular death,
myocardial infarction also known as MI and stroke among diabetic
patients on hemodialysis. After 11.5 years of follow up in both
groups, daily atrovastin or placebo, 90% of the patients had died
despite the fact that the patients who were given atrovastin during
the trial had an average reduction in LDL cholesterol levels by 42%.
In the New York Times October 22, 2013 Dr Hosam Kamel, the vice
chairman of the American Medical Directors Association, a group
representing physicians in nursing home practice, said there was
scarce scientific evidence supporting the use of statins in 70 to 80
year olds in their care. He said that the results don't conclusively
establish the benefits of using statins for seniors and he went on to
say there is evidence of harm linked to statin use in seniors
including muscle aches, liver toxicity, gastrointestinal distress, and
growing evidence of impaired memory, heightened risk of diabetes and
increased risk of cancer.
According to Dr Rita Redberg, cardiologist at the University of
California San Francisco Medical Center and editor in chief of JAMA
the side effects associated with statin use was not reported in
studies. According to her summary of the evidence for using statins to
prevent heart disease, heart attacks will be prevented in only 1 or 2
out of every 100 healthy people with high cholesterol who take statins
for 5 years while 1 person out of those 100 will develop diabetes and
older people are much more vulnerable to the side effects of the
medications. She also says there is some evidence that low cholesterol
is associated with higher mortality at an older age.
Back in 2009 I appeared on KSCO Radio's The Wellness Hour with Bernie
Owens. (link is coming soon) Back then on that show I laid out the
facts about cholesterol and statin drugs as I saw them using the drug
manufacturers own research to back up my opinions.
I pointed out back then that inflammation was a better predictor of
cardiovascular events than cholesterol. In fact I stated on that show
that cholesterol had NOTHING TO DO WITH HEART DISEASE, that it was
actually a warning sign.
I laid out how, when you actually look at a lot of the research on
statin drugs and look at the raw numbers, not the conclusions at the
beginning and end of the articles but the raw numbers, many times
there wasn't any real significant, statistical difference in outcomes
of cholesterol lowering from the placebo groups.
I showed that statin drugs actually do 2 things.
- it's true they lower cholesterol but
- they are actually anti-inflammatory as well and it was this property
that produced the positive cardiovascular benefits.
I showed that lowering cholesterol numbers actually caused many other
problems ranging from issues with muscles because of co Q 10
depletion, low testosterone, low vitamin d, increased risk of cancer,
and increase risk of Alzheimer disease. So it is really refreshing now
to have a well-known cardiologist back up some of what I said back
then.
See my blog post, "Truth About Cholesterol"
http://pharmacistkeith.blogspot.com/2011/09/truth-about-cholesterol.html
http://keithabell.info/2013/10/are-your-prescriptions-making-you-sicker.html
The Key to Winning
Occasionally I like to share something I read. Today I want to share with you a message from Denis Whitley. I've been reading and listening to Dr Whitney's thoughts for decades starting with a series of audio cassettes called The Psychology of Winning. I hope you enjoy his post and find value in his words.
Keith Abell, RPh MI
If I could show you how to eliminate
your two largest monthly expenses
would you give me 20 minutes?
(502) 212-2929
The Key to Winning by Denis Waitley
People often ask me, what is the most critical attribute of a winner in life? Without hesitation, I answer that believing you deserve to win is the key. If you believe in your dreams when they're all you have to hang on to, you begin to try. If you feel you have potential or talent, you'll invest in it. If you believe you're worth the effort, you'll put in the time and energy. If you think you can, you'll learn how.
Healthy self-esteem is perhaps the most important and basic quality of a winning human being. You want to be able to say: "I like myself. Given my parents and my background, I'm glad I'm me. I realize I may not be the best-looking in the group, but I always look and do my best in every group. I'd rather be me than anyone else in the world." This is the self-talk of a winner. Winners have developed a strong sense of self-worth, regardless of their status. They weren't necessarily born with these good feelings, but they've learned to like themselves through practice.
The most successful companies in the world know that valued employees are their most precious resource. Valuable employees pass their value on to customers. The result? Excellence and quality. They are the most powerful competitors in the world marketplace. Instead of comparing ourselves to others, we should view ourselves in terms of our own abilities, interests and goals. We can begin by making a conscious effort to upgrade our lifestyle, education and personal development. You always project on the outside how you feel on the inside.
Core values radiate like rings, as when a pebble is thrown in a pond. The self-centered constantly seek approval from and power over others. They try to impress them with their worth rather than express concern for others' well-being. And their outward appearances usually involve ways to hide their real thoughts and intentions.
The value-centered give of themselves freely and graciously, constantly seeking to empower others. Open and modest, they have no need for conceit, the opposite of core value. Feeling good about who they are, and not needing to talk about their victories or line their walls with celebrity photos, people with core values spend much of their time "paying value," as I call it, to others. When praised, they share the spotlight. When they make mistakes, they view them as learning experiences and accept responsibility.
Keith Abell, RPh MI
If I could show you how to eliminate
your two largest monthly expenses
would you give me 20 minutes?
(502) 212-2929
The Key to Winning by Denis Waitley
People often ask me, what is the most critical attribute of a winner in life? Without hesitation, I answer that believing you deserve to win is the key. If you believe in your dreams when they're all you have to hang on to, you begin to try. If you feel you have potential or talent, you'll invest in it. If you believe you're worth the effort, you'll put in the time and energy. If you think you can, you'll learn how.
Healthy self-esteem is perhaps the most important and basic quality of a winning human being. You want to be able to say: "I like myself. Given my parents and my background, I'm glad I'm me. I realize I may not be the best-looking in the group, but I always look and do my best in every group. I'd rather be me than anyone else in the world." This is the self-talk of a winner. Winners have developed a strong sense of self-worth, regardless of their status. They weren't necessarily born with these good feelings, but they've learned to like themselves through practice.
The most successful companies in the world know that valued employees are their most precious resource. Valuable employees pass their value on to customers. The result? Excellence and quality. They are the most powerful competitors in the world marketplace. Instead of comparing ourselves to others, we should view ourselves in terms of our own abilities, interests and goals. We can begin by making a conscious effort to upgrade our lifestyle, education and personal development. You always project on the outside how you feel on the inside.
Core values radiate like rings, as when a pebble is thrown in a pond. The self-centered constantly seek approval from and power over others. They try to impress them with their worth rather than express concern for others' well-being. And their outward appearances usually involve ways to hide their real thoughts and intentions.
The value-centered give of themselves freely and graciously, constantly seeking to empower others. Open and modest, they have no need for conceit, the opposite of core value. Feeling good about who they are, and not needing to talk about their victories or line their walls with celebrity photos, people with core values spend much of their time "paying value," as I call it, to others. When praised, they share the spotlight. When they make mistakes, they view them as learning experiences and accept responsibility.
7 Steps to Becoming a Network Marketing Professional
I highly recommend this book by Eric Worre. By following his advice and training I have had enormous growth in my organization since the first of this year. Over twenty years ago at a company convention, Eric Worre had an aha moment that changed his life forever. At that event he made the decision to Go Pro and become a Network Marketing expert. Since that time, he has focused on developing the skills to do just that. In doing so, Eric has touched and been touched by hundreds of thousands of people around the world. Now he shares his wisdom in a guide that will ignite your passion for this profession and help you make the decision to Go Pro and create the life of your dreams.
In this definitive guidebook, you will learn to: -Find prospects -Invite them to your product or opportunity -Present your product -Follow up with your prospects -Help them become customers or distributors -Help them get started right -Grow your team by promoting events -And much, much more. Eric s wish is for you to make the decision to become a Network Marketing Professional. For you to truly Go Pro. Because it is a stone-cold fact that Network Marketing is a better way. Now let s go tell the world.
Dr. Joel Wallach’s Selenium Research Continues to Benefit Many
Dr. Joel Wallach's Selenium Research Continues to Benefit Many
(come meet Dr Wallach, April 30 at 6:30 pm Holiday Inn East - Hurstbourn.)
FDA Now "Urging" Selenium be added to Baby Food Formulas!
San Diego, CA - April 22, 2013 -Youngevity® Essential Life Sciences, a wholly-owned subsidiary of AL International, Inc. (OTC Pink: JCOF), announces that the research of Youngevity® founder, Dr. Joel D. Wallach, BS, DVM, ND, on Selenium continues to be at the forefront of health and prevention with the recent U.S. Food and Drug Administration (FDA) proposed rule requiring the addition of selenium to the list of required nutrients for infant formula products.
Dr. Joel Wallach has been at the front line of Selenium research for nearly 40 years. Selenium is an essential trace mineral that serves many functions in human physiology, including the synthesis of antioxidants (natural substances that neutralize free radical damage), and thyroid and immune function. In 2003, along with Youngevity®, Dr. Wallach successfully petitioned the FDA to establish a Qualified Health Claim for selenium adding that it "may reduce the risk of certain cancers" to labels of dietary supplements containing Selenium.
Dr. Wallach was also the recipient of the Klaus Schwarz Medal in 2011 for his observation done as a researcher at the Yerkes Primate Research Center in Atlanta, Georgia in 1978. Dr. Wallach discovered pancreatic lesions in selenium deficient monkeys identical to those found in human patients discovering the link between selenium deficiencies and some forms of cystic fibrosis; making some forms of cystic fibrosis preventable in humans. This prestigious medal is awarded by the International Association of Bioinorganic Scientists, Inc., honoring trace element researchers for their accomplishments.
Through Dr. Wallach's research, Youngevity® has been able to provide its distributors with high-quality nutrition products based on his concept that there exist a core group of 90 essential nutrients (which includes selenium) that are necessary for optimal health. Specifically, Youngevity® offers a Healthy Heart & Brain Pak™ that not only contains the 90 essential nutrients, but also Youngevity's Award Winning Ultimate™ Selenium to help combat free radical damage.
Youngevity CEO, Steve Wallach, said "My father, Dr. Wallach, has been lecturing on the health benefits of selenium for over 30 years and continues to lecture almost daily, traveling 300 days a year in order to get the message out to the world. It is his belief, and Youngevity's, that the public is better off by getting the most information available to them in order to come to an educated decision regarding their own health."
About Dr. Joel Wallach
Before becoming a Naturopathic Physician in 1982, biomedical research pioneer, Dr. Joel D. Wallach, BS, DVM, ND spent two decades in the field of Veterinary Medicine, observing and researching the effects of individual nutrients on animal health. Today, Dr. Wallach is renowned for his groundbreaking research on the health benefits of selenium and other minerals. He currently dedicates his time to lecturing throughout the world on the therapeutic benefits of vitamins and minerals, and on lobbying the U.S. Food and Drug Administration on behalf of the dietary supplement industry.
About Youngevity Essential Life Sciences
Youngevity® Essential Life Sciences (www.youngevity.com ), headquartered in San Diego, CA, is a nutrition and lifestyle-related services company dedicated to promoting vibrant health and flourishing economics. Founded in 1997 by Drs. Joel Wallach, DVM, ND, and Ma Lan, MD, as AL Global, Inc., the Company adopted the name Youngevity in 2006. Youngevity® is the only direct selling company to have a qualified FDA Health Claim. Dr. Wallach's work has been published in more than 70 peer-reviewed and referenced scientific journals and books.
About AL International
AL International, Inc. (OTC Pink: JCOF) (www.alintjcof.com) is a fast-growing, innovative, multi-dimensional company that offers a wide range of consumer products and services, primarily through person-to-person selling relationships that comprise a "network of networks." The Company also is a vertically-integrated producer of the finest coffees for the commercial, retail and direct sales channels. AL International was formed after the merger of Youngevity Essential Life Sciences (www.youngevity.com) and Javalution Coffee Company in the summer of 2011.
Safe Harbor Statement
This release includes forward-looking statements on our current expectations and projections about future events. In some cases forward-looking statements can be identified by terminology such as "may," "should," "potential," "continue," "expects," "anticipates," "intends," "plans," "believes," "estimates," and similar expressions. These statements are based upon current beliefs, expectations and assumptions and are subject to a number of risks and uncertainties, many of which are difficult to predict. The information in this release is provided only as of the date of this release, and we undertake no obligation to update any forward-looking statements contained in this release based on new information, future events, or otherwise, except as required by law.
AL International, Inc. - Investor Relations John Zervas 800-982-3189 X 6509
Keith Abell, RPh MI
If I could show you how to eliminate
your two largest monthly expenses
would you give me 20 minutes?
(502) 212-2929
(come meet Dr Wallach, April 30 at 6:30 pm Holiday Inn East - Hurstbourn.)
FDA Now "Urging" Selenium be added to Baby Food Formulas!
San Diego, CA - April 22, 2013 -Youngevity® Essential Life Sciences, a wholly-owned subsidiary of AL International, Inc. (OTC Pink: JCOF), announces that the research of Youngevity® founder, Dr. Joel D. Wallach, BS, DVM, ND, on Selenium continues to be at the forefront of health and prevention with the recent U.S. Food and Drug Administration (FDA) proposed rule requiring the addition of selenium to the list of required nutrients for infant formula products.
Dr. Joel Wallach has been at the front line of Selenium research for nearly 40 years. Selenium is an essential trace mineral that serves many functions in human physiology, including the synthesis of antioxidants (natural substances that neutralize free radical damage), and thyroid and immune function. In 2003, along with Youngevity®, Dr. Wallach successfully petitioned the FDA to establish a Qualified Health Claim for selenium adding that it "may reduce the risk of certain cancers" to labels of dietary supplements containing Selenium.
Dr. Wallach was also the recipient of the Klaus Schwarz Medal in 2011 for his observation done as a researcher at the Yerkes Primate Research Center in Atlanta, Georgia in 1978. Dr. Wallach discovered pancreatic lesions in selenium deficient monkeys identical to those found in human patients discovering the link between selenium deficiencies and some forms of cystic fibrosis; making some forms of cystic fibrosis preventable in humans. This prestigious medal is awarded by the International Association of Bioinorganic Scientists, Inc., honoring trace element researchers for their accomplishments.
Through Dr. Wallach's research, Youngevity® has been able to provide its distributors with high-quality nutrition products based on his concept that there exist a core group of 90 essential nutrients (which includes selenium) that are necessary for optimal health. Specifically, Youngevity® offers a Healthy Heart & Brain Pak™ that not only contains the 90 essential nutrients, but also Youngevity's Award Winning Ultimate™ Selenium to help combat free radical damage.
Youngevity CEO, Steve Wallach, said "My father, Dr. Wallach, has been lecturing on the health benefits of selenium for over 30 years and continues to lecture almost daily, traveling 300 days a year in order to get the message out to the world. It is his belief, and Youngevity's, that the public is better off by getting the most information available to them in order to come to an educated decision regarding their own health."
About Dr. Joel Wallach
Before becoming a Naturopathic Physician in 1982, biomedical research pioneer, Dr. Joel D. Wallach, BS, DVM, ND spent two decades in the field of Veterinary Medicine, observing and researching the effects of individual nutrients on animal health. Today, Dr. Wallach is renowned for his groundbreaking research on the health benefits of selenium and other minerals. He currently dedicates his time to lecturing throughout the world on the therapeutic benefits of vitamins and minerals, and on lobbying the U.S. Food and Drug Administration on behalf of the dietary supplement industry.
About Youngevity Essential Life Sciences
Youngevity® Essential Life Sciences (www.youngevity.com ), headquartered in San Diego, CA, is a nutrition and lifestyle-related services company dedicated to promoting vibrant health and flourishing economics. Founded in 1997 by Drs. Joel Wallach, DVM, ND, and Ma Lan, MD, as AL Global, Inc., the Company adopted the name Youngevity in 2006. Youngevity® is the only direct selling company to have a qualified FDA Health Claim. Dr. Wallach's work has been published in more than 70 peer-reviewed and referenced scientific journals and books.
About AL International
AL International, Inc. (OTC Pink: JCOF) (www.alintjcof.com) is a fast-growing, innovative, multi-dimensional company that offers a wide range of consumer products and services, primarily through person-to-person selling relationships that comprise a "network of networks." The Company also is a vertically-integrated producer of the finest coffees for the commercial, retail and direct sales channels. AL International was formed after the merger of Youngevity Essential Life Sciences (www.youngevity.com) and Javalution Coffee Company in the summer of 2011.
Safe Harbor Statement
This release includes forward-looking statements on our current expectations and projections about future events. In some cases forward-looking statements can be identified by terminology such as "may," "should," "potential," "continue," "expects," "anticipates," "intends," "plans," "believes," "estimates," and similar expressions. These statements are based upon current beliefs, expectations and assumptions and are subject to a number of risks and uncertainties, many of which are difficult to predict. The information in this release is provided only as of the date of this release, and we undertake no obligation to update any forward-looking statements contained in this release based on new information, future events, or otherwise, except as required by law.
AL International, Inc. - Investor Relations John Zervas 800-982-3189 X 6509
Keith Abell, RPh MI
If I could show you how to eliminate
your two largest monthly expenses
would you give me 20 minutes?
(502) 212-2929
Multiple Sclerosis - Mineral Deficiencies
MS - Mineral Deficiencies
I was just completed a continuing education program on Multiple Sclerosis for my Pharmacist License requirements. The interesting thing about MS is the medical system doesn’t really know the causes. There are all kinds of theories about the cause but so far continued research has not proven any of them to be the definitive cause. It seems every time they think they have found something other research finds people with MS that don’t fit into the profile. My personal opinion is that there is not one particular cause. That MS is actually a symptom of multiple mineral and micro-nutrient deficiencies.
We know from research that large populations of MS sufferers come from areas where there are lower levels of sunlight during the winter months. The hypothesis is that Vitamin D – the sunshine vitamin therefore plays some role. This is probably true but since there are people suffering from the disease that do not have low Vitamin D levels we know it is not the only cause.
Many theorize that it is an auto-immune disease, where the immune system itself turns on the body causing damage. I have never been a big proponent of the auto-immune hypothesis. My question is always what started the immune system to turn on in the first place. To me the auto-immune hypothesis of any disease is much like the debate about whether a higher power, ie God, exist and is the cause for creating the universe. For many years the “Big Bang” has been promoted by science as the moment of creation of the Universe. My question is what then caused the Big Bang. Another example, for many years scientist thought the atom was the smallest particle but we now know that there are even smaller particles combined to make the atom and I am sure we will continue as technology allows to find even smaller and smaller particles. I believe the whole thing about auto-immune being the cause of so many diseases is just as flawed as these other theories have been proven to be.
In my opinion so called auto-immune diseases are actually caused by underlying deficiencies in the 90 essential nutrients that the body needs for optimal health. These 90 essential nutrients are involved in an unlimited amount of bio-chemical processes throughout the body and we have only scratched the surface of understanding what role these micro-nutrients play.
Just as an example in MS, we know that something causes the myelin sheaths around the nerve fibers to become inflamed and to become scarred. Science has yet to find one single cause of this probably because there are a multitude of different bio-chemical process that affect the myelin, problems with any one of these processes lead to similar damage. We know that there are a number of micronutrients involved with the overall health of the brain and nervous system yet we do not know every micronutrient and we do not know all the effects of deficiencies and combination of deficiencies have on the overall health. It is my opinion that the cause of this disease is multiple micro-nutrient deficiencies and the best way to prevent this disease and other auto-immune diseases is to supplement with all 90 known essential nutrients at levels according to ones body weight. I have seen other auto-immune diseases go into remission and I believe the same can be accomplished here.
Unfortunately, with the way that research is funded, most research money is spent trying to find medications to treat symptoms. Medications that can be patented and large profits made, whereas micro-nutrients, since they are naturally occurring, can’t be patented so research in these areas are not funded.
Here is a list of just some of the micro-nutrients used by the brain taken from an article from “Mineral Resources International, Inc’s” web site
( http://www.mineralresourcesint.com/basic/micronutrients-and-brain-function ). Remember this is only a partial list, we know that the human body actually needs 90 essential nutrients for optimal health.
Consequences of Select Micronutrient Deficiencies
Thiamin
Phosphorylated forms of thiamin (vitamin B1) are required for reactions involved in the metabolism of carbohydrates, amino acids, and lipids, and one form of the vitamin has been implicated in membrane functions of neurons and in the generation of nerve impulses. Thus, inadequate intake of thiamin can negatively affect cognition. Severe thiamin deficiency causes beriberi; the dry and wet types of beriberi involve peripheral neuropathy, whereas cerebral beriberi can lead to cell death of neurons and the clinical conditions of Wernicke's encephalopathy and Korsakoff's psychosis, especially in those who abuse alcohol.
Niacin
Niacin (vitamin B3) is needed for a number of redox reactions (reduction—"electron gain", oxidation—"electron loss") and other reactions in the body. Severe niacin deficiency, known as pellagra, has been historically associated with poverty and consumption of a diet predominantly based on corn, which is low in bioavailable niacin. Today, the condition is uncommon but can occur in cases of chronic alcoholism and in individuals with malabsorption syndromes. Neurologic symptoms of pellagra include headache, fatigue, apathy, depression, ataxia, poor concentration, delusions, and hallucinations, which can lead to confusion, memory loss, psychosis, dementia, and death.
Pantothenic Acid
Pantothenic acid (vitamin B5) is needed for the oxidative metabolism of glucose and fats and also for synthesis of fats, cholesterol, steroid hormones, the hormone melatonin, and the neurotransmitter acetylcholine. Pantothenic acid deficiency is very rare and has been observed only in cases of severe malnutrition. However, deficiency of this vitamin has been induced experimentally in humans by co-administering a pantothenic acid antagonist and a pantothenic aciddeficient diet. Participants in this experiment complained of headache, fatigue, insomnia, intestinal disturbances, and numbness and tingling of their hands and feet.
Experimentally induced pantothenic acid deficiency in laboratory animals has been shown to cause loss of the myelin sheath and peripheral nerve damage.
Vitamin B6
Pyridoxal, pyridoxine, and pyridoxamine are collectively called vitamin B6, which is required for the biosynthesis of several neurotransmitters, including GABA, dopamine, norepinephrine, and serotonin. Severe deficiency of vitamin B6 is uncommon, but alcoholics are thought to be most at risk due to inadequate dietary intakes and impaired metabolism of the vitamin. Neurologic symptoms of severe vitamin B6 deficiency include irritability, depression, confusion, and seizures.
Biotin
Biotin (vitamin B7) is required for carboxylase enzymes that are important in the metabolism of fatty acids and amino acids. While overt biotin deficiency is quite rare, deficiency of the vitamin has been observed in patients on prolonged intravenous feeding (parenteral nutrition) without biotin supplementation, in individuals consuming high amounts of raw egg white containing a protein that binds biotin and prevents its absorption, and in those with inherited disorders of biotin metabolism. Neurologic symptoms of biotin deficiency include depression, lethargy, hallucinations, and numbness and tingling of the extremities.
Folate
Folate (vitamin B9) is required for the metabolism of nucleic acids (DNA and RNA) and amino acids. The vitamin is also needed for the synthesis of several neurotransmitters, including norepinephrine, dopamine, and serotonin, and, along with vitamin B12, folate is required in the breakdown of norepinephrine and dopamine. Dietary folate deficiency in the absence of vitamin B12 deficiency does not cause neurologic symptoms. However, individuals with genetic disorders of folate metabolism have experienced seizures and progressive neurologic deterioration.
Vitamin B12
In humans, vitamin B12 is a required cofactor for two enzymes: methionine synthase, which is needed for the production of methionine from homocysteine, and L-methylmalonyl-CoA mutase, which is involved in crucial metabolic pathways. Vitamin B12 deficiency affects 10-15% of adults over the age of 60 years. It damages the myelin sheath of nerves and is frequently associated with neurological problems. Neurologic symptoms are the only clinical indicator of vitamin B12 deficiency in about 25% of cases. Such symptoms include numbness and tingling of the extremities, difficulty walking, problems with concentration, memory loss, disorientation, and dementia. Severe B12 deficiency is associated with pernicious anemia and, if untreated, can lead to "megaloblastic madness," characterized by delusions and hallucinations. Atrophic gastritis, an age-related condition resulting in diminished digestive factors, is often associated with decreased absorption of vitamin B12 from food.
Vitamin C
Vitamin C accumulates in the central nervous system, with neurons of the brain having especially high levels. Vitamin C is an important antioxidant that is required for the synthesis of the neurotransmitter norepinephrine, the reduction of metal (e.g., iron, copper) ions in the brain, and for the regeneration of vitamin E. Vitamin C deficiency causes oxidative damage to lipids and proteins in the brain. Severe vitamin C deficiency, called scurvy, is potentially fatal. In scurvy, vitamin C is retained by the brain for neuronal function, and eventual death from the disease is more likely due to lack of vitamin C for the synthesis of collagen—an important structural component of blood vessels, tendons, ligaments, and bone. Vitamin C is also required for the conversion of dietary lysine to carnitine, a compound essential for energy production in the cells' mitochondria. Hence, scurvy is characterized by fatigue and depression in addition to physical manifestations.
Vitamin D
Vitamin D is important for normal brain development and function, and vitamin D deficiency may impair cognitive abilities. Some studies in older adults have either linked lower 25-hydroxyvitamin D levels—the clinical indicator in the blood of vitamin D status&mdwith measures of poor cognitive performance or higher 25-hydroxyvitamin D levels with measures of better cognitive performance. However, the association between 25-hydroxyvitamin D concentrations and cognitive performance is not yet clear.
Vitamin E
In the brain and other tissues, the alpha-tocopherol form of vitamin E is a key fat-soluble antioxidant that prevents lipid peroxidation and helps to maintain the integrity of cell membranes. Thus, vitamin E deficiency causes lipid peroxidation in brain tissues. Severe vitamin E deficiency results mainly in neurological symptoms, including impaired balance and coordination (ataxia), injury to the sensory nerves (peripheral neuropathy), muscle weakness (myopathy), and damage to the retina of the eye (pigmented retinopathy).
Calcium
Calcium ions are important intracellular signals that regulate a number of physiological processes, including neuronal gene expression and neuronal secretion of neurotransmitters. Normal blood levels of calcium are maintained even when dietary intake of calcium is inadequate because the skeleton provides a large reserve of the mineral. Thus, dietary calcium inadequacy primarily affects bone health.
Iodine
Iodine is required for the synthesis of thyroid hormones, which are important for myelination of the central nervous system. Iodine is critical for normal development of the brain; therefore, deficiency of this mineral during critical periods of fetal development or childhood can have deleterious effects on cognition. The most extreme cognitive effect of developmental iodine deficiency is irreversible mental retardation; milder cognitive effects include various neurodevelopmental deficits, including intellectual impairment.
Iron
Iron is an essential component of hundreds of proteins and enzymes involved in various aspects of cellular metabolism. The mineral is needed for proper development of oligodendrocytes (the brain cells that produce myelin) and for several enzymes that synthesize neurotransmitters. Accordingly, iron deficiency during various stages of brain development has negative consequences. Maternal iron deficiency during pregnancy has serious consequences for the woman and the fetus, including permanent learning and memory deficits in the offspring. Iron deficiency during childhood may be associated with impaired cognitive development.
Magnesium
Magnesium is required for more than 300 metabolic reactions, many of which are important for normal brain function. Overt magnesium deficiency has been induced experimentally and results in neurologic and muscular symptoms that include tremor, muscle spasms, and tetany (involuntary muscle contractions). According to recent surveys, many Americans do not have an adequate intake of magnesium.
Selenium
Selenium is required for glutathione peroxidases (GPx), important antioxidant enzymes in the brain and other tissues. Selenium deficiency has been associated with decreased GPx activity in the brains of laboratory animals and may be linked to a reduced antioxidant capacity in the brain.
Zinc
Zinc is present at high levels in the brain, where it has catalytic, structural, and regulatory roles in cellular metabolism. In the brain, most of the zinc ion is tightly bound to proteins, but free zinc is present in synaptic vesicles and has a role in neurotransmission mediated by glutamate and GABA. Experimentally induced zinc deficiency in humans has been shown to impair measures of mental and neurologic function. However, deficiency of the mineral during critical periods of cognitive development can be more devastating, causing congenital malformations or deficits in attention, learning, memory, and neuropsychological behavior.
Choline
Although not considered a vitamin, choline is an essential nutrient needed for myelination of nerves, synthesis of the neurotransmitter acetylcholine, and synthesis of various structural and cell-signaling molecules, including phospholipids (phosphatidylcholine and sphingomyelin) that are important components of cell membranes. Choline deficiency during the perinatal period in laboratory animals results in persistent memory and other cognitive deficits in offspring.
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