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Be smart about your heart <br> with B-complex vitamins

Be smart about your heart
with B-complex vitamins

By Jolie Root, LPN, LNC

The B-complex vitamins are vitally important to our health and longevity. Without them we cannot produce energy; assimilate the many different nutrients from our foods; produce the brain chemicals we need to learn, remember, and support healthy mood and aging of the brain; and maintain a strong and healthy heart and system of blood vessels. As important as the B vitamins are to lifelong health, I often encounter avid supplement users who fail to take either a multivitamin or a separate B complex. Many people cannot rely on diet alone to yield optimal levels of the B vitamins because refining and processing removes a large percentage of B vitamins from foods. The B-complex family of nutrients includes thiamin (B1),riboflavin (B2), niacin (B3), pantothenic acid (B5), vitamin B6, biotin, vitamin B12, and folic acid. Many of the B vitamins play a role in supporting heart health directly or in changing our chemistry to protect against the development of conditions that place our hearts at risk. If you have issues with cholesterol, lipoprotein-a, or triglycerides, niacin may be a godsend.

Biotin supports normal glucose regulation. Impaired glucose regulation, sometimes called insulin resistance or prediabetes, puts us at risk of heart disease. There’s a link between diabetes, heart disease, and stroke. In fact, two out of three people with diabetes die from heart disease or stroke. So protecting healthy blood-sugar regulation is a very good idea for lifelong heart health. Research shows that a biotin deficiency may negatively affect glucose function, and people with type 2 diabetes may improve blood sugar control by supplementing with biotin. This B vitamin may also help to lower triglycerides in people with elevated levels. Biotin increases the production of glycogen, a stored form of glucose, which may explain its glucose-regulating and triglyceride-reducing actions.

Folic acid works with vitamins B6 and B12 to regulate levels of homocysteine, an amino acid produced in the body as a consequence of eating meat. If all is well, homocysteine is chemically transformed into methionine and cysteine (similar amino acids) with the help of folic acid, vitamin B12, and vitamin B6. But when we are depleted of the B vitamins, homocysteine levels may become elevated. Elevated homocysteine is considered a risk factor for cardiovascular disease, but that’s not all. Homocysteine may also contribute to a host of other conditions such as miscarriages and pregnancy difficulties, bone fractures, strokes, blood clots, depression, dementia, and Alzheimer’s disease. Due to homocysteine’s contributing role in a host of diseases, individuals at risk for high homocysteine levels should strongly consider a supplement regimen that includes vitamins B12 and B6 and folic acid. Along with the B-complex vitamins, also consider taking betaine to support the conversion of homocysteine to methionine, cysteine, or glutathione. Be aware that lipid-lowering medications known as fibrates have been shown to increase homocysteine levels. The diabetes drug metformin (Glucophage) has also been linked to elevated homocysteine levels.

Although the research is mixed for finding a reduced heart risk when homocysteine levels were lowered, there is good reason to keep your levels within normal range. A number of unhealthy changes may occur in blood vessels when we have too much homocysteine. Adverse effects include increased blood clotting, stiffening or loss of elasticity of the blood vessels, thickening of the blood vessel walls, and poor blood vessel health in general. Homocysteine can also damage the three main blood vessel connective tissue structures, making arteries and veins more susceptible to vascular disease. Those who have had angioplasty are especially known to benefit from supplementation with folic acid, B6, and B12. Angioplasty is the technique of mechanically widening a narrowed or blocked blood vessel. In those who have undergone this procedure, treatment with the triple B-vitamin combination significantly lowered plasma homocysteine levels and, at follow-up, the blood vessel diameter was significantly larger in the treatment group, the degree of blockage was less severe, and the rate of recurrent blockages was significantly lower. Stroke patients in particular are likely to benefit from getting healthy levels of folic acid. Researchers at Northwestern University’s Feinberg School of Medicine conducted a metaanalysis of eight significant studies and found that supplementation with folic acid reduced levels of homocysteine by 20 percent and lowered first-time risk of a stroke by 18 percent.

Niacin is another B-complex family member that is used to change cardiovascular risk for the better. Niacin lowers cholesterol levels and is sometimes prescribed in a timed-release form along with statin medications to improve lipid levels. Studies find improvement of lipid levels with the combination of niacin and medications or even with timed-release niacin alone. Four major studies found niacin supplementation to be significantly beneficial for both men and women. Niacin therapy raises HDL (high-density lipoprotein, or healthy) cholesterol levels, decreases lipoprotein-a (considered a risk factor for heart disease), and transforms the harmful small, dense LDL (low-density lipoprotein) to the benign large, buoyant LDL particles; all of these changes in lipids protect the heart and blood vessels.If you have issues with cholesterol, lipoprotein-a, or triglycerides, niacin may be a godsend. However, before rushing into taking a high dose of niacin, be aware that you may experience a flush. A niacin flush is by no means dangerous, but it is uncomfortable. Your blood vessels dilate, you feel warm and even itchy, and your face, arms, and hands may turn a bright red. But the flush passes after 30 minutes or so and it’s harmless. Another concern with higher doses of niacin is irritation of the liver. This is rare with straight niacin. Liver enzyme elevation is more common in those who use the sustained release form of niacin, which is released slowly into the system to help prevent flushing. To be on the safe side, with daily doses of 1,000 mg or more, it is wise to have periodic liver tests to monitor liver health. If liver enzymes become elevated when you take niacin, discontinuing the niacin will allow the liver enzymes to quickly return to normal. Most people will tolerate the active dose of sustained-release niacin needed to favorably impact serum lipid levels, which is 500 mg three times daily.

A nonflushing, alternative to niacin is vitamin B5 in the pantethine form. Vitamin B5 or pantothenic acid supports the production of some hormones and neurotransmitters, and it is involved in the metabolism of all carbohydrates, fats, and proteins. Once it is absorbed, pantothenic acid is converted to a compound called pantethine, which is the form of pantothenic acid found in supplements. Pantethine has been shown to help reduce triglyceride levels, lower LDL cholesterol, and increase beneficial HDL cholesterol. Pantethine is especially effective at lowering elevated blood lipids in patients with diabetes without affecting blood-sugar control. The typical dose of pantethine used to support normal cholesterol and triglyceride levels is 300 mg three times daily. Do not sell yourself short when it comes to nutrition for a healthy heart. Eat a diet comprised of whole foods rather than refined and processed foods, and include a balanced B complex to maintain healthy levels of B vitamins. Give your body the folic acid, B vitamins, and other nutrients, such as the omega-3s, it needs for a strong, healthy heart.

The Linus Pauling Institute, Nutritional Medicine by Alan R. Gaby, MD (Fritz Perlberg Publishing, 2011)
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