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Pernicious anemia

Supplementation with B vitamins

A high level of blood serum homocysteine (known as “homocysteinemia”) is associated with pernicious anemia. Because supplementation of the B vitamins lower levels of homocysteine, one common intervention for altering this risk factor is to supplement patients at risk for cardiovascular disease with folic acid (B9), pyridoxine (B6), and cyanocobalamin (B12). In fact, interventions designed to lower levels of homocysteine with high-dose supplementation of the B vitamins been equivocal, in some cases, seeming to exacerbate disease.

  • A 2010 study by House et al. has shown substantial adverse outcomes associated with high-dose B vitamins in patients with advanced diabetic nephropathy.1) These side effects included myocardial infarction, stroke, revascularization, and all-cause mortality. According to one commentator, unless other explanations come to light in further analyses of the study, these findings make repetition of a similar trial in this high-risk patient group unethical.
  • The Heart Outcomes Prevention Evaluation (HOPE-2) study, involved 5,522 patients with vascular disease or diabetes mellitus and found no effect of high-dose B6, B9 and B12 cosupplementation on death from cardiovascular disease, whereas the risk of stroke was decreased and the risk of unstable angina requiring hospitalization was increased.2)

Marino et al. showed that eradication of Helicobacter pylori associated with gastritis reduced abnormally high levels of homocysteine.3)

Given the fact that the B vitamins probably interfere with the immune response to microbes, MP patients should avoid taking supplemental doses of vitamin B12.

Evidence of infectious cause

Sample PubMed cite4)

Dear MPKB Reader: You have arrived at one of the articles that has not yet completed the development and review process in the knowledge base. Some of the content here may be helpful, but please know that this page is not complete. There are about 400 articles in the KB, and this is one we are still working on. Thanks for your patience.

Notes and comments

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GETCONTENT

  • legacy content

Sallie Q 10.22.2016 removed ref to curemy

Lots of discussion about PA and B12 deficiency here: http://curemyth1.org/view_topic.php?id=2626&forum_id=2

Lots of content here: http://www.curemyth1.org/forum2/2626.html

References

1)
Effect of B-vitamin therapy on progression of diabetic nephropathy: a randomized controlled trial.
House AA, Eliasziw M, Cattran DC, Churchill DN, Oliver MJ, Fine A, Dresser GK, Spence JD
JAMA303p1603-9(2010 Apr 28)
2)
Homocysteine lowering with folic acid and B vitamins in vascular disease.
Lonn E, Yusuf S, Arnold MJ, Sheridan P, Pogue J, Micks M, McQueen MJ, Probstfield J, Fodor G, Held C, Genest J Jr
N Engl J Med354p1567-77(2006 Apr 13)
3)
Long-term effect of Helicobacter pylori eradication on plasma homocysteine in elderly patients with cobalamin deficiency.
Marino MC, de Oliveira CA, Rocha AM, Rocha GA, Clementino NC, Antunes LF, Oliveira RA, Martins AS, Del Puerto HL, D'Almeida V, Galdieri L, Pedroso ER, Cabral MM, Nogueira AM, Queiroz DM
Gut56p469-74(2007 Apr)
4)
Vitamin D discovery outpaces FDA decision making.
Marshall TG
Bioessays30p173-82(2008 Feb)
home/diseases/pernicious_anemia.txt · Last modified: 02.20.2017 by sallieq
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