Only 12 months ago, Dutch and American researchers at the same time established that in individuals with an elevated level of homocysteine - which is very common and most often is a result of a lack of folic acid or vitamin B12 - the risk of hip fractures is doubled. It was a purely statistical connection, but is there a cause and effect relationship too?
Can folic acid and/or vitamin B12 really reduce the risk of breaking the hip; i.e. the most dangerous consequence of osteoporosis?
Only few people have thought of this possibility before, but at the moment it seems to be accurate. Japanese doctors have had this suspicion for at least five years. In the year 2000 they started a two-year treatment study in order to investigate the matter.
The study involved 628 particularly exposed elderly patients who were given a solid dose of the two vitamins: 5 mg. of folic acid and 1.5 mg. of vitamin B12 a day. However, half the patients were given placebo (dummy tablets). The 628 patients were chosen because they had previously suffered a stroke and were still more or less unilaterally paralyzed a year after the incidence. In this situation, the risk of hip fractures is doubled, particularly because the risk of falling is increased.
During the two years of the study, it was registrered how often the patients in the two groups had falls. The number of falls in the two groups was the same, but the consequences were a lot milder in the ones who had been given supplements. Only six individuals in this group suffered a hip fracture while the same was the case in 27 of the individuals in the placebo group. The risk, therefore, seems to be reduced by more than 80%. The patients who were given vitamins had a reduction in their blood homocysteine level of more than 30% while the homocysteine levels in the placebo group actually increased by the same amount.
Vitamin B deficiency destroys connective tissues
More and more evidence is put forward in support of the argument that homocysteine can be dangerous to the bones. The news is that it is of use to reduce the level of homocysteine if it is too high. Not because more calcium will enter the bones, because according to a Dutch study from 2004, this will not happen. However, there is reason to believe that the bones you do have will get stronger.
Biochemical studies have shown that homocysteine attacks both the elastic fibres and other kinds of fibres in bone- and connective tissues making the structure more loose, the wickerwork less tight, and the bones more stiff. The same kind of fibres can also be found in the arteries which, therefore, might also be damaged, and chemically similar proteins are part of the coagulation process of the blood. Some people believe that this explains the increased tendency of coronary thrombosis etc. that can be seen in relation to high homocysteine levels. The argument is supported by the fact that blood clots and weak bones can be observed particularly early on in people with the congenital disease homocystinuria in which the blood level of homocysteine is 10 times higher than normal. It has been said that the difference between people suffering from homocystinuria and other people is only the time at which the damages occur.
If the Japanese study is confirmed, folic acid and vitamin B12 is simply the most effective known protection against osteoporosis to date! In any case, it will not be a bad idea to have your blood level of homocystine measured. It should not exceed 10 mmol/l.
References:
Sato Y, Honda Y, Iwamoto J, Kanoko T, Satoh K. JAMA. 2005 Mar 2;293(9):1082-8. Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial.
Krumdieck CL et al. Mechanisms of homocysteine toxicity on connective tissues: Implications for the morbidity of aging. J Nutr. 2000;130:365S-368S.
Van Meurs Joyce B J et al. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med 2004;350:2033-41.
Mc Lean Robert R et al. Homocysteine as a predictive factor for hip fracture in older persons, N Engl J Med 2004;350:2042-9.
