B-vitamin therapy looks promising for staving off Alzheimer’s disease

Last year, I reported on research which found that supplementation with the vitamins B6, B12 and folic acid had been found to reduce the brain shrinkage (brain atrophy) in individuals suffering from ‘mild cognitive impairment’ (impaired brain function not severe enough to be labelled ‘dementia’) [1]. Subsequent research found that this treatment regime actually improved brain functioning [2].

The presumed mechanism involved here concerns the amino acid homocysteine – raised levels of which are associated with an increased risk of dementia. Vitamin B6 and B12 and folic acid have the capacity to lower homocysteine levels in the body. Interestingly, the previous research found that supplementation benefitted those who, prior to the study, had elevated levels of homocysteine, but not those with normal levels. This finding does support the idea that elevated levels of homocysteine can damage the brain, and that bringing levels down helps preserve brain functioning.

This week saw the publication of another follow-up study regarding this research. In this study, the impact of supplementation on the brain areas particularly affected by Alzheimer’s disease including the grey matter (outermost part of the brain) in a part of the brain known as the medial temporal lobe [3]. Compared to people taking placebo (inactive pills), atrophy here in those taking B vitamins was reduced by 90 per cent.

In summary, the research shows:

  • B12, B6 and folic acid found to reduce brain atrophy in those with elevated levels of homocysteine
  • In these people, B12, B6 and folic acid supplementation was found to improve brain function
  • In these people, B12, B6 and folic acid supplementation was found to dramatically reduce brain shrinkage in the part of the brain most affected in Alzheimer’s disease

Lead researcher in this work, Professor David Smith, is listed as an inventor on patents held by Oxford University for B vitamin formulations to treat mild cognitive impairment and Alzheimer’s disease. However, taking the research at face value, what we have here is evidence that B-vitamin supplementation is a legitimate strategy for those suffering with mild cognitive impairment and raised homocysteine levels (the level of homocysteine used as the threshold for ‘raised’ homocysteine in these studies was 11 µmol/L).

What is strange about this research, I think, is how little impact it has had in some quarters of the medical and scientific communities. UK journalist Jerome Burne has been following the story throughout, and wrote this week about this latest study on his blog. Jerome, in his post, also examines some of the political reasons which might explain why the reaction to this research which has enormous implications has been somewhat lukewarm. You can read Jerome’s post here.


1. Smith AD, et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One 2010;5(9):e12244.

2. de Jager CA, et al. Cognitive and clinical outcomes of homocysteine-lowering B-vitamin treatment in mild cognitive impairment: a randomized controlled trial. Int J Geriatr Psychiatry. 2012;27(6):592-600

3. Douaud G, et al. Preventing Alzheimer’s disease-related gray matter atrophy by B-vitamin treatment. PNAS published 20 May 2013

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14 Responses to B-vitamin therapy looks promising for staving off Alzheimer’s disease

  1. Jeff 23 May 2013 at 5:57 pm #

    Its amazing how effective B6 B9 B12 are at improving cognitive health. Combined with phosphatidylserine, coq10 and glutathione you can not only stave off Alzheimer’s but dramatically improve mental performance. Very good article on an important subject.

  2. JT 23 May 2013 at 9:08 pm #

    A little bit different from what you wrote, but thought to write about my families theory for Alzheimer’s disease. Alzheimer’s is something my family is concerned about. The reason for that concern is due to a great grandmother passing from the brain wasting disease in the 1960s. Around 10 years ago her daughter (my grandmother) passed from Alzheimer’s also. With two relatives having had the deadly condition, it has caused us remaining family members to be concerned about a possible genetic link to developing Alzheimer’s disease.

    It is often said that a warning sign for developing Alzheimer’s is having a poor ability to spell, in particular having difficulty spelling easy, small words. In my family my father is a poor speller, so is my sister, and I have this difficulty too ( much to the amazement of my mother who won a college scholarship to become an English teacher.). The common idea promoted to improve spelling is simply to practice. In my family, all three of us could practice memorizing words all day long, and still have great difficulty on spelling exams.

    My family theory about this goes like this – I have an IBD stomach condition. As a result I’m often playing with my diet, following different diets such as paleo, low carb, elimination diets to improve my condition. I know from past experience when eating very limited diets I was able to go into remission with my gut woes. So it would seem there are a few trigger foods that cause my gut problem. Trying to figure out these foods is highly difficult. I’m currently working on this, and having some decent success of late.

    The part where this ties in with my family, and maybe Alzheimer’s is, when I’m on a diet where I’m well to the gut completely, it seems my spelling and writing difficulties go away. Spelling becomes quite easy when well to the gut.

    So if there is a connection to poor spelling abilities and developing Alzheimer’s disease late in life, I’m hoping if I figure out the foods that distress my gut, leading to my poor spelling abilities, that what I figure out will help others in the family, preventing others from developing Alzheimer’s.

  3. Chris 24 May 2013 at 10:52 am #

    For those 25% of us with the “Alzheimer’s gene” – apoE 4/4 or 3/4 – this is very useful research. I will be checking my homocysteine annually. This is also a good marker for coronary inflammation (which apoE 4 carriers are also susceptible )

  4. William L. Wilson, M.D. 24 May 2013 at 10:55 am #

    John—thanks for the excellent article. High homocysteine runs in our family so this is a topic dear to my heart. There are two issues that I would add to the discussion—the importance of eating a healthy diet and the importance of L-methylfolate if you have a high homocysteine.

    My grandmother liked to bake—cookies, pies, bread were her favorites and whatever she baked she ate. She developed obesity in her 30’s, type II diabetes in her 40’s and Alzheimer’s disease in her 50s. She died in her 60s.

    My mother (her daughter) didn’t like to bake so much. When I was growing up she feed us healthy food even as my friends developed a taste for junk food. Pearl never developed obesity or type II diabetes. She did develop Alzheimer’s disease about 20 years ago. Today she is still going strong at 95. When I called her on Mother’s Day, she thanked me for the flowers. Her physicians can’t figure out why she isn’t dead. After all, in this country Alzheimer’s disease is typically a 10-year disease.

    I know the answer to this puzzle. We now believe that the combination of excessive fructose mainly from sugar and HFCS, high glycemic carbohydrates mainly from grains and excessive omega 6 fatty acids from vegetable oils is responsible for triggering a form of food-induced brain dysfunction called Carbohydrate Associated Reversible Brain Syndrome or CARB syndrome. Patients with CARB syndrome develop brain dysfunction symptoms that interfere with their ability to function. If you add CARB syndrome to a brain disorder like Alzheimer’s disease, it’s like adding gas to a fire—not a good situation.

    Learn more at:


    If you have a high homocysteine you should take L-methylfolate as a supplement rather than folic acid. Folic acid needs to be converted to L-methylfolate in order to cross the blood-brain barrier. You need folic acid in your brain in order to make monoamine neurotransmitters like dopamine and serotonin. People with a high homocysteine level don’t produce enough L-methylfolate.

  5. Modesty 24 May 2013 at 10:56 am #

    Of course B vitamins is not of interest – no pharmaceutical moneys to make. I’m curious if there’s been any additional research or data on blood ketones (whether from ketogenic diet or adding coconut oil to the diet) impact on Alzheimer’s or other neurodegenerative diseases, probably no research money at all.

  6. Fiona 24 May 2013 at 11:44 am #

    To JT – Have you tried a gluten-free diet for your IBD? Many people are finding that, though not frankly coeliac, they are sensitive to guten and feel much better when avoiding it. This doesn’t mean buying expensive gluten-free products but just avoiding wheat, barley and rye and instead eating whole-grain rice, corn, etc. It does not mean you need to cut out all carbs. There’s a lot of information on the internet.

  7. Rose 24 May 2013 at 11:49 am #

    Dear Dr Briffa, thank you for your newsletter which is always interesting. Please could you give me your opinion about taking the large doses of B vitamins required to help Alzherimer’s. would it be OK to use ordinary vitamins from the chemist or health shop, and would it be safe to take them in the quantities that I believe were used in the trial: 2,000-3,000mg niacinanide, 20mg B6, 500mcg B12 (in spray form) and 800mcg folic acid. I appreciate your taking the time to advise me about this.

  8. david manovitch 24 May 2013 at 12:30 pm #

    I am always a little sceptical of vitamin and mineral quick fixes for human ills, though this research is encouraging, notwithstanding the professor’s financial interest. After all, we know how pharmaceutical companies financial interest affect their industry sponsored research. As others have stated, you can’t beat a healthy diet.

    The medical profession, of which I’m a member, is very conservative and always slow to catch on to new ideas. The problem lies not only with their conservatism and reluctance to believe anything that they were not taught in medical school, but also due to the fact that most doctors are extremely busy, and only have time to read a select few medical journals. As far as I can see they are not exposed to cutting-edge biological research in non-medical publications. I first came across homocysteine as a marker for disease processes in the alternative therapies literature about 15 years ago. It took many years before I noted any mention of it in medical literature.

  9. Chloe 24 May 2013 at 2:28 pm #

    I like to take a naturally derived supplement rather than these ‘white pills’ which are jsut synthesised in a factory. Natures Plus is my fave!

  10. Eddie Mitchell 24 May 2013 at 5:24 pm #

    As a type two diabetic, diet controlled plus Metformin I keep my eye on B12 levels with blood tests. Long term Metformin use is known to deplete B12. While talking to an expert, I stated I make sure I use foods that are high in B12 such as liver, beef and eggs. I was informed as people age they can have trouble getting the B12 they require from foods. I was also told supplements can prove ineffective and patients need to receive a quarterly injection of B12. My B12 levels at the moment are OK. Can Dr. Briffa confirm I have received sound advice, thank you.

  11. carter 24 May 2013 at 8:19 pm #

    Dear Dr Briffa,

    Thank you as always for this and the many other articles of great interest.

    I am also curious as to how much of each vitamin might be recommended for general usage. Thanks much.

  12. Vince 25 May 2013 at 11:30 pm #

    Eddie,I too am a T2DM and also happen to be a Dr. Good diabetic control on low carb diet for 15 years,and a bit of a committed bicycle rider, now that I am older and no longer a runner. And also using Metformin. As you know,one of the few drugs with runs on the board in this condition. Although the drug guys are madly searching for the holy grail, and the much touted lifestyle changes invariably contain a “balanced” diet with lots of carbs with every meal. Yes,sadly same old rubbish trotted out downunder. Homocysteine levels have been a long term blood test in my standard work up. No problem getting it done here in Australia where I live and it is said to be within normal range below 11. Good evidence regarding B12 too where the levels are said to be preferably above 400. Certainly that’s where I keep mine. Metformin can lead to malabsorption of B12, and I advise all my patients with lower levels to have 1000 mcg daily and repeat levels a month or so later and with later monitoring 1 or 2 tablets per week often is all that’s needed. Only if there is no response elevation to oral Rx should injectable B12 be given and often only as a kickstart ,following which tablets often work well. But if not then you may have Pernicious anaemia and that is of course, a completely different and medically important scenario needing thorough investigation.

  13. Deane Alban 26 May 2013 at 9:28 pm #

    I don’t think it’s strange that the medical community is ignoring this research. I find it pretty typical and very sad. I don’t think the establishment really wants to cure this disease. The ALZ.org, the world’s largest Alzheimer’s organization, is a lumbering giant closely aligned with the medical establishment. Peruse their site and you’ll find more links that lead to requests for donations, joining walk-a-thons, or becoming a corporate sponsor than you will find ways to prevent this disease.

    They have the nerve to have trademarked the phrase “Maintain Your Brain”®, yet the information on their site about how to do that is almost non-existent. They recommend staying mentally, physically, and socially active and eating a healthy diet. As if we didn’t already know that.

  14. Eddie Mitchell 28 May 2013 at 11:41 am #

    To Vince

    Thank you for taking the time to post your information. I have copied and kept the post should I have a B12 problem in the future. As with all things medical very little is as straightforward as we would like.

    “Although the drug guys are madly searching for the holy grail, and the much touted lifestyle changes invariably contain a “balanced” diet with lots of carbs with every meal. Yes, sadly same old rubbish trotted out down under”

    I believe high fat low carb is the holy grail as I am sure you believe. At the moment over two hundred meds are being considered by big pharma for the control of diabetes. Will we be reading about these drugs in the same light as Avandia and Actos in a few years time. Low carb high fat will cost big pharma $billions over time and don’t they know it.

    Kind regards Eddie

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