By Catherine Guthrie
George Sisco was near the breaking point. Throughout ten years of grappling with major depression, he had tried several antidepressants, with disappointing results. The drugs enabled him to function, but not much more. They never really made him feel good. And far too often, their side effects left him reeling.
Then he came across an article about how researchers were using vitamin B-12 to increase people’s responses to prescription antidepressants, and for the first time, he felt a flicker of hope. “Heck, I’d try just about anything,” says the 60-year-old in Clearwater, Florida.
So he bought a bottle of B-12 supplements and began taking one each day in combination with his latest antidepressant. Within three weeks he felt a marked improvement. “I got a feeling of well-being that made it easier to accomplish all sorts of tasks,” he says. Now, nearly a year later, he takes a B complex vitamin every other day, and feels better than he has in years. “I don’t understand how the vitamins work, but I know I feel better when I take them,” he says. “And that’s enough for me.”
Could something as simple as a B vitamin ease one of our most tenacious mental health problems? For years, scientists have known that severe B deficiencies can take a toll on the mind, causing confusion, irritability, and memory loss. But the recent discovery that subtle, less obvious, shortfalls may also cause problems suggests the answer might well be yes.
Not only that, studies also suggest that B vitamins might help stave off Alzheimer’s disease. So if you struggle with depression, or fret about a future lost to dementia, there’s reason to take this news seriously. Here’s what you need to know.
Bs for the blues
Of the B vitamins that fuel the brain’s feel-good chemistry, folic acid and vitamin B-12 are at the head of the class. Without plenty of these two substances, the body slacks off its production of SAMe (short for S-adenosylmethionine), an important mood regulator that boosts serotonin levels in the brain. Lagging levels of both nutrients can also directly interfere with levels of serotonin as well as dopamine, which the brain needs to stay on an even keel.
George I. Papakostas, a clinical instructor of psychiatry at Harvard Medical School, is one of the most prominent researchers in the field of B vitamins and depression. In his latest study, he found that depressed patients with low folic acid levels were not only more likely to have a relapse during treatment, they were less likely to respond to antidepressants. He suspects that because they were low in folic acid, their bodies’ SAMe levels were also low.
“The evidence connecting low folate and depression is very strong,” he says. He recommends folic acid supplements for many of his depressed patients, particularly if they don’t respond well to drug therapy. And that can be a pretty big group. In a given year, nearly one out of ten Americans will struggle with depression, but up to 40 percent of them won’t respond well to prescription antidepressants.
In the case of vitamin B-12, the link to depression is more tenuous. The vitamin has piqued researchers’ interest because of its role in formulating SAMe. And studies show that up to 30 percent of people hospitalized for depression have low blood levels of B-12. But the relationship between vitamin B-12 and depression has a bit of a chicken-or-egg quality, since depressed people often don’t eat a very healthy diet. Does a B-12 deficiency cause depression or is it simply a byproduct of poor eating habits?
There’s some compelling evidence that the problem starts with B. In the study that caught George Sisco’s attention, in the December 2003 issue of BioMed Central Psychiatry, Finnish researchers followed 115 patients with major depressive disorder for more than six months. In the end, those who experienced a greater than 50 percent reduction in symptoms had the highest blood levels of B-12.
No one understands exactly how vitamin B-12 might lift depression, but experts do know that the sheath surrounding the delicate nerves of the brain and spine suffers when the body is denied the vitamin. And this damage is what leads to the symptoms of B-12 deficiency, including numbness and tingling in the arms and legs, memory loss, and dementia. Indeed, Alzheimer’s disease is the other main area that excites vitamin B researchers.
Keeping Alzheimer’s at bay
Most Alzheimer’s and B vitamin studies focus on B-12 and folate, but scientists at the Rush Institute for Healthy Aging in Chicago recently discovered a link between Alzheimer’s disease and niacin (aka B-3). The researchers asked 815 people age 65 and older to complete a diet questionnare; then, after four years, all of the participants underwent a clinical evaluation for Alzheimer’s. It turned out that those who got the most niacin (36 to 171 milligrams a day) were 80 percent less likely to suffer from Alzheimer’s than those who got the least (7 to 15 mg).
Martha Morris, an epidemiologist and the study’s lead researcher, says it isn’t clear how niacin protects against Alzheimer’s. But, she adds, “we do know niacin is important for keeping neurons healthy.” If future studies confirm Morris’s results, niacin may be an easy way to shield the brain from the deadly disease.
But there’s no reason to wait, since foods high in niacin, like whole grains, legumes, and nuts, are things people should be eating anyway, especially as they get older. People over 60 are at risk of B-vitamin deficiency because the gut’s ability to absorb nutrients slows as the body ages.
Also, older folks have less stomach acid, which is crucial for tussling vitamin B-12 away from protein, thereby making it more accessible to the body. The result? As many as 15 percent of Americans over age 65 are deficient in B-12. “My findings are just one more reason to eat well,” Morris says.
There’s one area in which B vitamins haven’t particularly borne out their promise. For years, practitioners have doled out B to patients who are stressed and anxious. However, though these problems seem related to depression, they don’t involve the same brain chemistry patterns. And according to Jonathan Alpert, a physician and associate director of the Depression Clinical and Research Program at Massachusetts General Hospital in Boston, there’s no scientific research to back up the practice.
“Taking a B vitamin won’t hurt,” he says, “but there’s never been proof that B vitamins relieve stress.”
User’s Guide: B Vitamins
What they’re good for: Helping stave off Alzheimer’s disease and making people suffering from depression more likely to respond to drug therapy
Where to get them: A healthy diet is the best way to load up. Niacin is plentiful in peanuts, fish, and meat; vitamin B-12 is found in meat, poultry, and fish; folic acid abounds in dark green leafy vegetables and fortified cereals and pasta. But not everyone has an easy time coaxing food into unleashing its vitamin B stores. Consider supplemental B if you suffer from depression (particularly if you don’t regularly eat a healthy diet), are over age 60, or have a hard-to-treat intestinal disorder such as irritable bowel syndrome. In the latter two cases your body’s ability to absorb nutrients is seriously curtailed.
Finally, vegans need to be especially concerned about vitamin B-12, since it’s found only in animal products. Although some food makers claim their vegan products contain B-12, no vegan food has yet to consistently deliver on that promise. Even nutritional yeast, which is marketed as a reliable vegan source of vitamin B-12, is not a foolproof solution.
Dosage: For depression, take a complex B-50 vitamin twice a day. For Alzheimer’s, take a B-100 vitamin once a day.
Risks: The only risk is from niacin; more than 500 mg a day can cause a burning, flushing, or tingling sensation on the skin.
Tip: Some practitioners claim injections of vitamin B-12 can relieve symptoms caused by disorders ranging from multiple sclerosis to Alzheimer’s disease. There’s no scientific evidence to back the practice, but many people have reported improvements. If you’re desperate for help, an injection of B-12 won’t hurt, since the body excretes extra B-12 in the urine.